Transcript Ch 13 Power Point

Chapter 13: Stress, Coping,
and Health
The Relationship
Between Stress and Disease
• Prior to the 20th century, the principal threats
to health were contagious diseases caused
by infectious agents: smallpox, diphtheria,
etc.
• Nutrition, public hygiene, and medical
treatment have obliterated many of these
diseases.
• Unfortunately, chronic diseases such as heart
disease and cancer, diseases that develop
gradually, continue to increase
The Relationship
Between Stress and Disease
– Biopsychosocial model: holds that physical
illness is caused by a complex interaction
of biological, psychological, and
sociocultural factors
– Health psychology: seeks to determine the
importance of psychological factors in
illness
• Health promotion and maintenance
–Discovery of causation, prevention,
and treatment
Figure 13.1 Changing patterns of illness
Stress: An Everyday Event
• Stress is defined in the text as any circumstances
that threaten or are perceived to threaten one’s well
being and that thereby tax one’s coping ability.
• Major stressors vs. routine hassles
– Cumulative nature of stress: minor stresses like
moving, experiencing changes in household
responsibilities, etc. can add up to be as stressful
as a major traumatic event like a divorce or
disaster
– Anxious-neurotic people feel more stress
– The experience of feeling stressed depends
largely on cognitive processes;
• People’s appraisals of events are very
subjective and influence the effect of the event.
Major Types of Stress
• Acute stressors:
– Threatening events with a clear endpoint
and are rather short in duration (speeding
ticket)
• Chronic Stress
– Long in duration with no clear endpoint
(neg. boss, mortgage loan)
Major Types of Stress
• Psychologists have outlined 4 principle types of
stress
• Frustration: blocked goal
– Very common in every day life
– Ex. traffic jams, waiting for ACT scores or college
admittance papers, breaking up
Major Types of Stress
• Conflict: two or more incompatible motivations or
behavioral impulses compete for expression (Lewin
and Miller)
– Approach-approach: when a person has a choice
between 2 attractive goals (least stressful- go on
vacation or buy a new TV)
– Approach-avoidance: when a choice must be
made about whether to pursue a single goal that
has both attractive and unattractive
aspects…results in vacillation, or going back and
forth (college in new city)
– Avoidance-avoidance: caught b/w a rock and a
hard place; choice between 2 unattractive choices
(Most stressful) (back surgery vs. back pain)
Figure 13.2 Types of conflict
Major Types of Stress
• Change: any noticeable alterations in one’s
living circumstances that require
readjustment;
– Change events seen as ‘positive’ can
produce as much stress as negative
– Social Readjustment Rating Scale: Holmes
and Rahe (1967)
• measure life change as a form of stress,
giving higher points (life change units)
for more stressful events
• Does not measure change exclusively
• Focuses on neg. events
Major Types of Stress
• Pressure
– expectations or demands that one behave
in a certain way
– pressure to perform or to comply
• Weiten Developed a Pressure Index with
a higher correlation than the SRRS to
psychological problems associated with
stress
Responding to Stress Emotionally
• Stress responses are multidimensional, including
emotional, psychological, and behavioral realms.
• Emotional Responses
– Annoyance, anger, rage
– Apprehension, anxiety, fear
– Dejection, sadness, grief
– Positive emotions: promoting creativity and
flexibility in problem solving, facilitating the
processing of important information about oneself,
and reducing the adverse physiological effects of
stress.
Responding to Stress Emotionally
• Emotional response and performance
– The inverted-U-hypothesis:
• The higher the difficulty a task is, lower
levels of emotional arousal are needed
• More simple tasks require a higher level
of emotional arousal
Figure 13.5 Arousal and performance
Stress and Positive Emotions?
• Do positive emotions disappear during times
of great stress?
– No, often times they increase (9/11
example)
– Moreover, the more positive emotions you
are able to exhibit, the greater resilience to
stress
Responding to Stress Physiologically
• Physiological Responses
– Fight-or-flight response: Walter Cannon (1932).
• The FF response is a physiological reaction to
threat in which the autonomic nervous system
(ANS) mobilizes the organism for attacking
(fight) or fleeing (flight) an enemy
• modern stressors are more long term (the
checkbook)
– Higher physiological reactions include:
higher consumption of oxygen, higher blood
pressure, dilated pupils, reduction in
digestive processes
Responding to Stress Physiologically
– Selye’s General Adaptation Syndrome:
theory about how stress reactions occur
• Alarm: an organism recognizes a threat
and mobilizes resources – essentially
enters the FF response
• Resistance: physiological arousal
stabilizes but is still above baseline, as
the organism copes with the stressor
• Exhaustion: the body’s resources are
depleted…Selye believed that this is
where diseases of adaptation come in.
Responding to Stress Physiologically
• Stress and the Brain
– Primary Path: Stress causes the
hypothalamus to activate the sympathetic
part of the ANS (main part are the adrenal
glands which release catecholamine to
cause the F-F response)
– Secondary Path: the hypothalamus causes
the pituitary gland to activate the adrenal
glands which secrete corticosteroids to
increase energy and reduce inflammation
Responding to Stress Behaviorally
• Behavioral Responses
– Frustration-aggression hypothesis: striking
out at others aggressively,usually the result
of frustration…(Dollard)
– Catharsis: purging of emotions (venting),
aggressive behavior leads to more
aggression
– defense mechanisms
• Coping: refers to active efforts to master,
reduce, or tolerate the demands created by
stress (can be positive or negative)
Responding to Stress Behaviorally
• Coping Mech:
– Giving up on oneself: passively accepting
setbacks that might be dealt with
effectively
• learned helplessness – passive behavior
produced by exposure to unavoidable
aversive events
• Blaming oneself: perpetuates negative
reactions and behaviors toward stress
• Neg. self-talk can lead to depression
Responding to Stress Behaviorally
• Coping Mech:
– self-indulgent (eating, drinking, smoking,
shopping, internet, pornography)
• Trying to solve problems by immersing
yourself in sub. forms of satisfaction
– defensive coping (erecting defense
mechanisms)
• Denial of Reality, Fantasy, isolation,
Undoing, Overcompensation
• Use the principle of self-deception
Responding to Stress Behaviorally
• Coping Mech:
– constructive coping
• confronting problems directly
• realistically appraising situations
• recognize and inhibit disruptive
emotional responses
• ensuring your body is not especially
vulnerable to stress
Figure 13.4 Overview of the stress process
Effects of Stress:
Behavioral and Psychological
• Roy Baumeister’s work shows that people
under pressure to perform may feel selfconscious, which leads to disruption of
attention and “choking” under pressure
– Impaired task performance
– Burnout: physical, mental, and emotional
exhaustion that is attributable to long-term
involvement in emotionally demanding
situations…loss of meaning.
Figure 13.7 The antecedents, components, and consequences of burnout
Effects of Stress:
Behavioral and Psychological
• Keinan (1987) also did stress studies
– He found that stress disrupts peoples
ability to focus attention
– They jump to decisions too quickly
– Unsystematically review options
– Basically, it is harder for people to
suppress competing thoughts
Effects of Stress:
Behavioral and Psychological
• Psychological problems and disorders: from sleep
problems and unhappiness, to full-fledged
psychological disorders such as schizophrenia and
depression
• Positive effects:
– stress can promote personal growth or selfimprovement, forcing people to develop new skills,
reevaluate priorities, learn new insights, and
acquire new strengths.
– Conquering a stressful challenge may also lead to
improved coping abilities and increases in selfesteem.
– What school of psyc?
Effects of Stress: Physical
• Psychosomatic diseases: physical ailments
with a genuine organic basis that are caused
in part by psychological factors, especially
emotional distress
– hypertension, ulcers, asthma, eczema, and
migraine headaches
– Heart disease accounts for nearly one-third
of the deaths in the U.S. each year
– Atherosclerosis, or gradual narrowing of
the coronary arteries, is the principle cause
of CHD
Effects of Stress: Physical
• Heart disease
– Type A behavior - 3 elements
• strong competitiveness
• impatience and time urgency
• anger and hostility (most important)
– Type B Behaviors (less likely)
• Relaxed
• Patient
• Easy going
• Amicable behavior
• One study found that patients with high hostility
ratings are twice as likely to develop Atherosclerosis
Figure 13.9 Anger and coronary risk
Effects of Stress: Physical
• Stress and immune functioning
– Emotional reactions can trigger cardiac symptoms
in patients with stable coronary disease.
– Depressive disorders may also be a risk factor for
heart disease, with some studies showing that the
risk of CHD is doubled with depression
– Stress has also been shown to decrease the
immune response, the body’s defensive reaction
to invasion by bacteria, viral agents, or other
foreign substances…decreasing white blood cells
called lymphocytes
Featured Study
• Used a longitudinal study (over 4 years)
– Does depression increase the risk of
cardiac mortality?
• Minor depression: 60% increase in heart
disease
• Major depression tripled the risk of
cardiac death
–Recent studies have found
depression doubles the chance of
heart disease and changes how it
develops
Table 13.4 Health Problems that may be Linked to Stress
Figure 13.11 The stress-illness correlation
Factors Moderating the Impact of Stress
• Social support
– Increased immune functioning
– decrease the negative impact of stress
• Optimism
– More adaptive and more effective coping
• Pessimistic explanatory style
– related to passive coping and poor health
practices.
Factors Moderating the Impact of Stress
• Conscientiousness
– Fostering better health habits
– related to increased longevity, possibly
because being conscientious leads better
preventive medicine
• Autonomic reactivity (physiological factors)
– Cardiovascular reactivity to stress
– appear to play a role in how significant the
impact of stress is on an individual.
Figure 13.12 The prevalence of smoking in the United States
Health-Impairing Behaviors
• Smoking
– A 25 year old male who smokes two packs a day
has an estimated life expectancy 13-14 years
shorter than that of a similar, nonsmoker.
– Health risks decline quickly for those who give up
smoking, but quitting is difficult and relapse rates
are high.
• Poor nutrition
– linked to heart disease, hypertension, and cancer,
among other things
• Lack of exercise (same as poor nutrition)
Figure 13.13 Quitting smoking and cancer risk
Health-Impairing Behaviors
• Alcohol and drug use
– carry the immediate risk of overdose and the longterm risk of many diseases
• Risky sexual behavior
• Transmission, misconceptions, and prevention of
AIDS
– HIV is transmitted through person-to-person
contact involving the exchange of bodily fluids,
primarily semen and blood
– Many young heterosexuals downplay their risk for
HIV, causing them not to adopt the behavioral
practices that minimize risk.
Development of Health-Impairing
Behavior
• 1) Health-Impairing Behaviors creep up
slowly
• 2) Many Health-Impairing Behaviors are quite
pleasurable
• 3) Most risks associated with HealthImpairing Behaviors are a long way off
• 4) People underestimate how these
behaviors will affect them and overestimate
their effect on others
Reactions to Illness
• Many reactions to illness are not conducive to health
– Seeking treatment
• Ignoring physical symptoms
– Communication with health care providers
• Barriers to effective communication
– Following medical advice
• Noncompliance with medical advice is a
serious issue.
• Noncompliance is more likely if instructions are
hard to understand, when they are difficult to
follow, and when patients are unhappy with
their doctor
Figure 13.16 Biopsychosocial factors in health