CHAPTER 14: Stress, Coping, & Health

CHAPTER 14: Stress, Coping, & Health

1. THE RELATIONSHIP BETWEEN STRESS AND DISEASE

   • contagious diseases = WAS the largest cause of death
     • NOW chronic diseases are; such as heart disease, cancer and stroke
   • Biopsychosocial Model: physical illness is caused by a complex interaction of biological, psychologic and social factors.
   • Health Psychology: how psychosocial factors relate to the promotion and maintenance of health; cause, prevention and treatment of illness
   • Stress: An Everyday Event
     • occurs when circumstances threaten/percieved to threaten an individuals well-being/tax their abilities
       • minor hassels accumulate = become stressful because of accumulation
     • stress is different for everyone
       • some people might stress about a plane ride, while others do not
     • Primary Appraisal: one's first evaluation of whether an event is: irrelevant, relevant but not threatening or stressful
     • Secondary Appraisal: when someone views the event as stressful and evaluate their resources/coping strategies
   • Major Types of Stress
     • Acute stressors: short with a clear end point
       • an exam
     • Chronic Stressors: long and don't have an end limit
       • caring for an autistic child
     • Frustration: occurs when someones goals are blocked
       • failures and losses
     • internal conflict: two or more incompatible motivations or behavioural impulses
       • Approach - Approach: a choice must be made between two attractive goals
         • you have a free afternoon: tennis or basketball?
       • Avoidance- Avoidance: a choice must be made between two unattractive goals
         • keep taking unemployment cheques or get a degrading job at the car wash?
       • Approach- Avoidance: a choice must be made about whether to pursue a single goal that has both attractive and unattractive aspects
         • you get a career promotion that means a large increase in pay but you have to move to a city that you don't want to
     • change: have to adapt to something
       • getting married after a long time of living alone
       • Holmes and Rahe - Social Readjustment Rating Scale (SRRS)
         • life change units: can be positive or negative stress and still be stressful
     • Pressure: time pressure as well as having to behave in certain ways
       • preform well
       • Weiten found that pressure was highly correlated with psychological symptoms that life changes on the SRRS
       • overworked nurses were 50% more likely to get heart disease than other subjects that were under pressure

2. RESPONDING TO STRESS

   • cognitive appraisal: ones personal perception of threat, which are influenced by familiarity with the event, its controllability, predictability..
     • a person has behavioural, emotional and/or physiological responses
   • 1. Emotional Responses
     • common emotional responses include: annoyance anger rage
       • apprehension, anxiety, fear
       • dejection, sadness, grief
     • positive emotions are apparent during times of severe stress
       • fortunate to be alive; appreciate what they have more than ever
       • associated with resiliency
       • associated with lower levels of stress hormones and higher immune functioning, longer life span, less likely to get colds
     • Effects of emotional Arousal - The Introverted U Hypothesis
       • for tasts of average complexity, you need a medium level of arousal
         • studying for an exam of average difficulty for you
         • if you had little arousal you would not care to study, if you had too much arousal you would be too anxious to study and wouldn't be able to concentrate
   • 2. Responding to Stress Physiologically
     • Flight or Fight Response: physiological response to threat in which the autonomic nervous system mobilizes one for attacking (fight) or escaping (flight) the attacker
       • By Walter Cannon (1932)
       • results in the sympathetic nervous system by increasing heart rate and breathing rate, and decreasing your digestive processes
     • Selve's General Adaptation Syndrome (1936) was the first researcher to identify and name stress; lab animals had similar physiological reactions to physical and psychological stress
       • 1. Alarm: physiological arousal occurs when the organism first recognizes threat
         • can also occur when small stresses accumulate
       • 2. Resistance: if stress is prolonged, chronic arousal can result.
         • arousal can level off if the mobilization of their coping resources- yet it still will remain higher than normal levels
       • 3. Exhaustion: resources are depleted, arousal decreases and animal collapses or have little resistance to diseases
       • Know Body-Brain Pathways in Stress: 2 pathways where the hypothalamus sends signals to the endocrine system
         • first path:autonomic nervous system is activated to cause the adrenal medulla to release big amounts of catecholamines (into bloodstream)
           • mobilizes body for action - increases heart rate; blood is pumped to brain, muscles; pupils dialate for better vision..etc.
         • second path signals the pituitary to secrete a hormone called ACTH and stimulates the adrenal cortex to release corticosteroids
           • increases energy and inhibits inflammation
         • men have higher stress reactions than women between puberty and menopause
           • causes them to have higher risk of cardiovascular disorders
   • 3. Responding to Stress Behaviourally
     • coping: active efforts to master, reduce or tolerate the demands created by stress
     • Learned helplessness (give it up): passive behaviour produced by exposure to unavoidable aversive events
       • increases distress if unless the goal is unattainable
       • unhealthy if it is excessive
     • Frustration Agression Hypothesis (striking out at others): states that aggression (intention to hurt someone) is always caused by frustration
       • catharsis: release emotional tension by being aggressive
         • can reinforce more aggression and invite aggression
     • indulging yourself: addictions
       • internet addiction: spending too much time on the internet and inability to control it
     • Constructive Coping: healthy efforts to deal with stressful events
       • confronting problems directly with action
       • inhibit disruptive emotional reactions
       • realistic appraisal of your stress and coping resources
       • make efforts to ensure your body is not being damaged by stress
     • Defence Mechanisms: are largely unconscious reactions that protect a person from unpleasant emotions such as anxiety and guilt
       • denial of reality: protecting oneself from unpleasant reality by refusing to perceive or fact it
         • ex: a smoker concludes that the evidence linking cigarette use to health problems is scientifically worthless
       • fantasy: gratifying frustrated desires by imaginary achievements
         • ex: a socially inept and inhibited young man imagines himself chosen by a group of women to provide them with sexual satisfaction
       • intellectualization (isolation): cutting off emotion from hurtful situations or separating incompatible attitudes so that they appear unrelated
         • ex: a prisoner on death row waiting execution resists appeal on his behalf and coldy insists that the letter of the law be followed
       • overcompensation: covering up felt weakness by emphasizing some desirable characteristic or making up for frustration in one area by over gratification in another
         • ex: a dangerously overweight woman goes on eating binges when she feels neglected by her husband
       • undoing: atoning for to trying to magically dispel unacceptable desires or acts
         • ex: a teenager who feels guilty about masturbation ritually touches door knobs a prescribed number of times following each occurrence of the act

3. EFFECTS OF STRESS ON PHYSIOLOGICAL FUNCTIONING

   • Impaired Task Performance: pressure to preform can lead to decreased performance
   • PostTraumatic Stress Disorders (PTSD): psychological disturbance due to a major traumatic event
   • Psychological Problems and Disorders: chronic stress can contribute to insomnia, sexual difficulties, alcohol and drug abuse
     • have a stress component in the etiology
   • Positive Effects: can lead to resilience and promote personal growth
     • people may develop new skills, re-evaluate priorities and enhance ones self concept
   • Burnout: physical and emotional exhaustion, cynicism, and lowered sense of self-efficacy brought on gradually by chronic work related stress
     • caused by: work overload, interpersonal conflicts, lack of control over work responsibilities and outcomes, little recognition
     • consequences: physical illness, increased absenteeism, decreased commitment to job, reduced productivity
   • Effects of Stress on Physical Health
     • Psychosomatic diseases: term was once used when a physical problem such as ulcers, was believed to be caused by stress
       • many diseases caused by stress
   • Type A Personality, Hostility and Heart Disease
     • Type A Behaviour: strong competitiveness; impatience and time urgency; anger and hostility
     • Type A: higher risk of heart disease
       • hostility seems to be the factor that carries the risk
     • Type B: relaxed; patient; easygoing; not competitive or easily angered
     • Precocity Longevity Hypothesis: states that people with early success may also die younger
       • could be due to Type A personality factors
   • Emotional Reactions, Depression, and Heart Disease
     • stress and depression have been found in heart patients - could be the cause of the disease
   • Stress and Immune Functioning
     • Immune response - body's defensive reaction to invasion by bacteria, viruses,...
     • The factors moderating the impact of stress include:
       • 1. social support - increased immune functioning
     • 2. optimism: more adaptive coping; pessimistic explanatory style; conscientiousness - live longer
     • 3. Health Impairing behaviours: smoking; poor nutrition; lack of exercise; alcohol and drug use; risky sexual behaviour; transmission, misconceptions, and prevention of AIDS
     • Reaction to Illness: seeking treatment or ignoring physical symptoms; communication with health care providers; barriers to effective communications; following medical advice vs. noncompliance

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