1. Professor Veronica Emilia Nuzzolo © 2013 The McGraw-Hill Companies, Inc. Introductory Psychology Concepts CHAPTER 11 HEALTH PSYCHOLOGY

2. © 2013 The McGraw-Hill Companies, Inc. 11-2 Health Psychology This branch of psychology addresses the factors related to well-being and illness, including the prevention, diagnosis, and treatment of medical problems. The study of stress and coping is a central focus of health psychology. Pain is another important topic because it is a central feature of many illnesses and a major stressor. Introductory Psychology Concepts: Health Psychology

3. © 2013 The McGraw-Hill Companies, Inc. 11-3 Stress and Well-being Stress is viewed in three different ways: 1. Stimulus 2. Response 3. Ongoing interaction between an organism and its environment Stress can be defined as: A pattern of cognitive appraisals, physiological responses, and behavioral tendencies that occurs in response to a perceived imbalance between situational demands and the resources needed to cope with them. Introductory Psychology Concepts: Health Psychology

4. © 2013 The McGraw-Hill Companies, Inc. 11-4 Stress and Well-being We refer to stress as a stimulus when we make statements such as, “I’ve got a lot of stress in my life right now. I have three exams next week, I lost my class notes, my fiancé just announced a vow of eternal celibacy, and my car broke down.” Introductory Psychology Concepts: Health Psychology

5. © 2013 The McGraw-Hill Companies, Inc. 11-5 Stress and Well-being Stress can also be a response that has cognitive, physiological, and behavioral components. Thus a person might say, “I’m feeling all stressed out. I’m tensed up, I’m having trouble concentrating on things, and I’ve been flying off the handle all week.” The presence of negative emotions is an important feature of the stress response and links the study of stress with the field of emotion (Zautra, 2003). Introductory Psychology Concepts: Health Psychology

6. © 2013 The McGraw-Hill Companies, Inc. 11-6 Stress and Well-being A third way of thinking about stress combines the stimulus and response definitions into a more inclusive model. In this case, stress is viewed as a person-situation interaction, or as an ongoing transaction between the organism and the environment (Lazarus, 1991, 1998). Introductory Psychology Concepts: Health Psychology

7. © 2013 The McGraw-Hill Companies, Inc. 11-7 Stressors Stressors are specific kinds of stimuli, whether physical or psychological, that place demands on our well-being and require us to adapt in some manner. Stressors differ in their severity: Microstressors: Daily hassles and minor annoyances. Major negative events: Death of a loved one, career of family failure, serious illness, or victim of a serious crime. Catastrophic events: Occur unexpectedly and affect large numbers of people, for example natural disasters or acts of terrorism. Introductory Psychology Concepts: Health Psychology

8. © 2013 The McGraw-Hill Companies, Inc. 11-8 Understanding the Types of Stress Uncontrollability: Running late, losing your keys, traffic, etc. Frustrations: The result of not being able to satisfy a motive Conflict: When two or more motives cannot be satisfied because they interfere with one another Pressure: Stress that arises from threat of negative events Environmental Conditions: Air pollution, noise, humidity, etc. Introductory Psychology Concepts: Health Psychology Stressful life events can range from catastrophic events to microstressors or daily hassles. Both types take their toll on physical and psychological well- being.

9. © 2013 The McGraw-Hill Companies, Inc. 11-9 Managing and Coping with Stress Strategies for coping with stress are divided into three main classes: Problem-focused coping: Dealing directly with the stressor to change or eliminate it. Emotion-focused coping: Working to emotionally manage one’s response to the stressor. Seeking social support: Turning to others for assistance and emotional support. Introductory Psychology Concepts: Health Psychology

10. © 2013 The McGraw-Hill Companies, Inc. 11-10 Stress A response to events that are threatening or challenging. Introductory Psychology Concepts: Stress Stress is a very personal thing. Although certain kinds of events, such as the death of a loved one or participation in military combat, are universally stressful, other situations may or may not be stressful to a particular person (Affleck et al., 1994; Krohne, 1996; Robert-McComb, 2001).

11. © 2013 The McGraw-Hill Companies, Inc. 11-11 Stress: What Occurs When Events are Identified as Threatening or Challenging Psychological: Emotions: anxiety, depression, anger, and irritability Cognitive: trouble concentrating and thinking clearly Motivation: change in appetite for food and sex In most cases, these psychological states are temporary, but if the stress is not dealt with properly it can lead to long- lasting changes. Introductory Psychology Concepts: Stress

12. © 2013 The McGraw-Hill Companies, Inc. 11-12 Stress: What Occurs When Events are Identified as Threatening or Challenging Physical: The General Adaptation Syndrome (GAS) suggests that there are three major stages to stress responses. (Source: Selye, 1976.) Introductory Psychology Concepts: Stress Stressor 2. Resistance Coping with stress and resistance to stressor. 1. Alarm and mobilization Meeting and resisting stressor. 3. Exhaustion Negative consequences of stress (such as illness) occur when coping is inadequate.

13. © 2013 The McGraw-Hill Companies, Inc. 11-13 Psychoneuroimmunology: The Study of the Effects of Stress, Emotions, Thoughts and Behavior on the Immune System Many contemporary psychologists specialize in psychoneuroimmunology (PNI), which takes a broader approach by focusing on the outcome of stress. Their findings point to three main outcomes: Direct physiological effects Harmful behavior Indirect Health-related behaviors Introductory Psychology Concepts: Stress

14. © 2013 The McGraw-Hill Companies, Inc. 11-14 Psychoneuroimmunology: The Study of the Effects of Stress, Emotions, Thoughts and Behavior on the Immune System Introductory Psychology Concepts: Stress Three major types of consequences result from stress: direct physiological effects, harmful behaviors, and indirect health-related behaviors. (Source: Adapted from Baum, 1994.) Direct physiological effects Elevated blood pressure Decrease in immune system functioning Increased hormonal activity Psychophysiological conditions Harmful behaviors Increased smoking, alcohol use Decreased nutrition Decreased sleep Increased drug use Indirect health-related behaviors Decreased compliance with medical advice Increase in delays in seeking medical advice Decrease in likelihood of seeking medical advice Stress

15. © 2013 The McGraw-Hill Companies, Inc. 11-15 Stress and Personality: Type A and Type B Personality Types When looking at stress, there are usually two different types of personalities that people will exhibit in their coping strategies. Introductory Psychology Concepts: Stress Type A personalities tend to live under great pressure and demand much of themselves and others. Many Type A personalities are classified as workaholics, continually striving to get more done in less time.

16. © 2013 The McGraw-Hill Companies, Inc. 11-16 Stress and Personality: Type A and Type B People labeled Type A exhibit characteristics such as being excessively competitive, hard-driven, impatient, and hostile. People labeled Type B show patience, serenity, and lack of time urgency; usually classified as noncompetitive, cooperative, and non-aggressive. Introductory Psychology Concepts: Stress

17. © 2013 The McGraw-Hill Companies, Inc. 11-17 Hardiness: Individuals Who Thrive on Stress Many people work and live in highly stressful environments, and yet seem to thrive on this life style. This is known as hardiness, a personality characteristic associated with a lower rate of stress-related illness. Three components of hardiness: Commitment: Viewing families, work, and other involvements as extremely important. Challenge: Believing that challenge, rather than stability, is the norm and should be embraced. Control: Assuming that people can influence and control the events in their life. Introductory Psychology Concepts: Stress

18. © 2013 The McGraw-Hill Companies, Inc. 11-18 Introductory Psychology Concepts: Stress Effects of Culture on Coping Many factors, including gender roles and culture, influence our tendency to favor one coping strategy over another. Men are more likely to use problem-focused coping as the first strategy when they confront a stressor (Ptacek et al., 1992). Women, who tend to have larger support networks and higher needs for affiliation than men, are more likely than men to seek social support (Billings & Moos, 1984; Schwarzer, 1998). Women are also more likely to use emotion-focused coping (Carver et al., 1989; Pearlin & Schooler, 1978).

19. © 2013 The McGraw-Hill Companies, Inc. 11-19 Introductory Psychology Concepts: Stress Effects of Culture on Coping The general pattern of coping preferences is consistent with the socialization that boys and girls traditionally experience. In most cultures, boys are pushed to be more assertive, independent, and self-sufficient, whereas girls are expected to be more emotionally expressive, supportive, and dependent (Eccles, 1991; Lytton & Romney, 1991). Common male response is “fight or flight,” whereas women are more likely than men to “tend and befriend.”

20. © 2013 The McGraw-Hill Companies, Inc. 11-20 Introductory Psychology Concepts: Stress Effects of Religion on Coping Psychologists of religion have looked at how individuals use religion as a resource in coping with stress. Attribution theory introduces three distinct styles of religious coping: 1. Deferring: people who leave their problems to God for resolution. 2. Collaborative: people who believe that a combination of divine influence and their own efforts are necessary to help them cope with stress. 3. Non-religious: people who do not appeal to God.

21. © 2013 The McGraw-Hill Companies, Inc. 11-21 Coping Efforts to control, reduce, or tolerate the threats that lead to stress are known as coping. We habitually use certain coping responses to deal with stress. Most of the time, we’re not aware of these responses—just as we may not be aware of the minor stressors of life until they build up to intolerable levels (Snyder, 199; Folkman & Moscowitz, 2000.) Introductory Psychology Concepts: Coping

22. © 2013 The McGraw-Hill Companies, Inc. 11-22 Dealing with Stress Problem-Focused Coping Attempts to modify the stressful problem or source of stress. Problem-focused strategies lead to changes in behavior or to the development of a plan of action to deal with stress. Emotion-Focused Coping People attempt to manage their emotions in the face of stress, seeking to change the way they feel about or perceive a problem. Includes strategies such as accepting sympathy from others and looking at the bright side of a situation. Introductory Psychology Concepts: Coping

23. © 2013 The McGraw-Hill Companies, Inc. 11-23 Concentrative and Receptive Meditation Coping-skills training can help people control their psychological responses in stressful situations. Meditation relaxes the body and produces cognitive relaxation, a peaceful, mind-clearing state Concentrative meditation focuses on the breath, an image, or a sound (mantra), in order to still the mind and allow a greater awareness and clarity about the body to emerge. Receptive meditation focuses on the quiet center, allowing relaxation to work progressively through the mind making it ever more still and empty, to allow a feeling of directionless "just sitting." Introductory Psychology Concepts: Coping

24. © 2013 The McGraw-Hill Companies, Inc. 11-24 Effects of Culture on Coping Many factors, including gender roles and culture, influence our tendency to favor one coping strategy over another. Men are more likely to use problem-focused coping as the first strategy when they confront a stressor (Ptacek et al., 1992). Women, who tend to have larger support networks and higher needs for affiliation than men, are more likely than men to seek social support (Billings & Moos, 1984; Schwarzer, 1998). Women are also more likely to use emotion-focused coping (Carver et al., 1989; Pearlin & Schooler, 1978). Introductory Psychology Concepts: Coping

25. © 2013 The McGraw-Hill Companies, Inc. 11-25 Effects of Culture on Coping The general pattern of coping preferences is consistent with the socialization that boys and girls traditionally experience. In most cultures, boys are pushed to be more assertive, independent, and self-sufficient, whereas girls are expected to be more emotionally expressive, supportive, and dependent (Eccles, 1991; Lytton & Romney, 1991). Common male response is “fight or flight,” whereas women are more likely than men to “tend and befriend.” Introductory Psychology Concepts: Coping

26. © 2013 The McGraw-Hill Companies, Inc. 11-26 Introductory Psychology Concepts: Coping Effects of Religion on Coping Psychologists of religion have looked at how individuals use religion as a resource in coping with stress. Attribution theory introduces three distinct styles of religious coping: 1. Deferring: people who leave their problems to God for resolution. 2. Collaborative: people who believe that a combination of divine influence and their own efforts are necessary to help them cope with stress. 3. Non-religious: people who do not appeal to God.

27. © 2013 The McGraw-Hill Companies, Inc. 11-27 Defense Mechanisms: Unconscious Distortions of Reality Defense mechanisms may help us feel better temporarily, but in actuality they distort our perceptions, which then inhibit long-term solutions to stress and effective coping. Examples include: Introductory Psychology Concepts: Coping Rationalization Repression Denial Intellectualization Displacement Sublimation Projection Reaction Formation Regression

28. © 2013 The McGraw-Hill Companies, Inc. 11-28 An immune system cell reaches out to capture bacteria, shown here in yellow. The bacteria that have already been pulled to the surface of the cell will be engulfed and devoured. Introductory Psychology Concepts: Immune System Immune System The system of cells, chemicals, and organs of the body that respond to attacks from diseases, injuries, and infections.

29. © 2013 The McGraw-Hill Companies, Inc. 11-29 Immune System Psychoneuroimmunology Investigates the relations between the psychophysiological and immunophysiological dimensions of living beings. Studies the effects of stress, emotions, thoughts, and behavior on the immune system. Introductory Psychology Concepts: Immune System