CHAPTER 13STRESS, COPING AND HEALTH

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CH. 13STRESSPsychological states cause physical illness.

Stress is any circumstance (real or perceived) that threatens a person’s well-being.

When we feel severe stress, our ability to cope with it is impaired.

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BEHAVIORAL MEDICINECenters for Disease Control (CDC) claim that half

of the deaths in the US are due to people’s behaviors (smoking, alcoholism, unprotected sex, insufficient exercise, drugs, and poor nutrition).

Psychologists and physicians have thus developed an interdisciplinary field of

behavioral medicine that integrates behavioral knowledge with medical knowledge.

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Stress can be adaptive. In a fearful or stress- causing situation, we can run away

and save our lives. Stress can be maladaptive. If it is prolonged (chronic

stress), it increases our risk of illness and health problems.

STRESS AND ILLNESS

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THE RELATIONSHIP BETWEEN STRESS AND DISEASEContagious diseases vs. chronic diseases

Biopsychosocial model

Health psychology• Health promotion and maintenance

• Discovery of causation, prevention, and treatment• Primary prevention, secondary prevention, tertiary prevention• Changing pattern of what is the primary cause of death in last 100+

years.

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Levels of Prevention

Primary Prevention•Prevent disease•Identify causes•Promote health behaviors

Secondary Prevention•Catch disease in early stages•Prevent further deterioration

Tertiary Prevention•Manage illnesses with nocure

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Figure 13-1, Changing pattern of illnessfor 100+ years

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STRESS: AN EVERYDAY EVENTMajor stressors vs. routine hassles

• Cumulative nature of stress• Psychological Stress - Lazarus• Cognitive appraisals: primary and secondary

Major types of stress• Frustration – blocked goal• Conflict – two or more incompatible motivations

• Approach-approach, approach-avoidance, avoidance-avoidance – • Change – having to adapt

• Holmes and Rahe – Social Readjustment Rating Scale – Life Change Units• Pressure – expectations to behave in certain ways

• Perform/conform• pressure and psychological symptoms –

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1)Potentially stressful objective events

2)Subjective cognitive appraisal3)Response

1)Emotional2)Physiological3)Behavioral

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RESPONDING TO STRESS EMOTIONALLY

Emotional Responses

• Annoyance, anger, rage• Apprehension, anxiety, fear• Dejection, sadness, grief• Positive emotions

Emotional response and performance

• The inverted-U-hypothesis • High emotion can sometimes negatively influence task

performance, more so for highly complex tasks and less so for simple ones

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RESPONDING TO STRESS PHYSIOLOGICALLY

Physiological Responses

• Fight-or-flight response

• Selye’s General Adaptation Syndrome• Alarm • Resistance• Exhaustion

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GENERAL ADAPTATION SYNDROME

According to Selye, a stress response to any kind ofstimulation is similar. The stressed individual goes

through three phases.

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THE STRESS RESPONSE SYSTEMCanon proposed that the stress response (fast) was a fight-or-

flight response marked by the outpouring of epinephrine and

norepinephrine from the inner adrenal glands, increasing

heart and respiration rates, mobilizing sugar

and fat, and dulling pain.

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RESPONDING TO STRESS BEHAVIORALLY

Behavioral Responses: Coping – emotion focused

•Frustration-aggression hypothesis

•catharsis

Defensive Coping – ego defense mechanisms –Freud –

Constructive Coping – problem focused

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EFFECTS OF STRESS: BEHAVIORAL AND PSYCHOLOGICAL

Impaired Task performance

Burnout – antecedent-components-consequences

Posttraumatic Stress Disorders (PTSD) – effects on hippocampus (cortisol) – slide prevelance of traumatic events

Psychological problems and disorders – more in Chapter 14

Positive effects – eustress – Positive Psychology

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PERSONALITY TYPESType A is a term used for competitive, hard-driving, impatient, verbally aggressive, and

anger-prone people. Type B refers to easygoing, relaxed people (Friedman and

Rosenman, 1974).

Type A personalities are more likely to developcoronary heart disease.

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PESSIMISM AND HEART DISEASE

Pessimistic adult men are twice as likely to develop heart disease over a

10-year period (Kubzansky et al., 2001).

Table of ContentsSelf-efficacy is the extent or strength of one's belief in one's own ability to complete tasks and reach goals.

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EFFECTS OF STRESS: PHYSICALPsychosomatic diseases

Heart disease

• Cholesterol and inflammation and risks – • Type A behavior - 3 elements

• strong competitiveness• impatience and time urgency• anger and hostility

• Emotional reactions and depressionStress and immune functioning

• Reduced immune activity • Possible health problems linked to stress • Stress-illness correlation

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STRESS AND COLDSPeople with the highest life stress scores

were also the most vulnerable when exposed to an experimental cold virus.

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STRESS AND AIDSStress and negative emotions may

accelerate the progression from human immunodeficiency virus (HIV) to acquired

immune deficiency syndrome (AIDS).

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STRESS AND CANCERStress does not create cancer cells.

Researchers disagree on whether stress influences the progression of cancer. However, they do agree that avoiding stress and having a hopeful attitude

cannot reverse advanced cancer.

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Table 13-4a, p. 531

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COPING WITH STRESSReducing stress by changing events that cause stress or by changing how we react

to stress is called problem-focused coping.

Emotion-focused coping is when we cannot change a stressful situation, and we respond

by attending to our own emotional needs.

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PERCEIVED CONTROLResearch with rats and humans indicates that the absence of control over stressors

is a predictor of health problems.

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EXPLANATORY STYLEPeople with an optimistic (instead of

pessimistic) explanatory style tend to have more control over stressors, cope better with stressful events, have better moods,

and have a stronger immune system.

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SOCIAL SUPPORTSupportive family members, marriage

partners, and close friends help people cope with stress. Their immune functioning calms the cardiovascular system and lowers blood

pressure.

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MANAGING STRESSHaving a sense of control, an optimistic

explanatory style, and social support can reduce stress and improve health.

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AEROBIC EXERCISECan aerobic exercise boost spirits? Many studies suggest that aerobic exercise can

elevate mood and well-being because

aerobic exercise raises energy, increases self-

confidence, and lowers tension, depression, and

anxiety.

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BIOFEEDBACK, RELAXATION, AND MEDITATION

Biofeedback systems use electronic devices to inform people about

their physiological responses and gives them the chance to

bring their response to a healthier range.

Relaxation and meditation have similar

effects in reducing tension and anxiety.

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LIFE-STYLEModifying a Type-A lifestyle may

reduce the recurrence of heart attacks.

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SPIRITUALITY & FAITH COMMUNITIES

Regular religious attendance has been a reliable predictor of a longer life span with a reduced risk of dying.

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INTERVENING FACTORSInvestigators suggest there are three

factors that connect religious involvement and better health.

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MANAGING STRESS: SUMMARY

How can stress be managed?

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TYPES OF CONFLICT—COMPLETE ON WHITE SCRATCH PAPER

Description in your own words Illustrated example

Approach-approach

Avoidance-avoidance

Approach-avoidance