Transcript Slide 1

Health
Social Psychology
Chapter 14
December 10, 2004
Class #14
Health Psychology

The application of psychology to the promotion
of physical health and the prevention and
treatment of illness
– Social psychological principles now involved in health
issues…that wasn’t always the case
– Modification of one’s lifestyle, outlook, and behavior
can lessen risk of such things as heart disease,
cancer, strokes, accidents, AIDS, etc.
– From following slide you can view the change in US
insofar as leading causes of death 
Leading Causes of Death, 1900-2000
Stress
The whole process by which we appraise and
respond to events that threaten or challenge us
 An unpleasant state of arousal that arises when
we perceive that the demands of an event
threaten our ability to cope effectively
 Subjective appraisal of the situation determines:

– How we will experience the stress
– What coping strategies we will use
Major Types of Stressors

Catastrophes
– Unpredictable, large scale events
 Natural disasters
– Cataclysmic events
 Sudden, without warning
– Ex: WTC tragedy
Significant Life Changes
 Daily Hassles

Scarring Effects of Natural Disasters

Krug et al. (1998)
– These researchers analyzed counties
that had experienced disasters
 Before/after research revealed some
alarming numbers
 See next slide 
Krug et al. (1998)
70
60
50
Increase in 40
Suicide Rate 30
20
10
0
Floods
Hurricances
Earthquakes
Type of Natural Disaster
Posttraumatic Stress Disorder (PTSD)

Up to 70% of adults in U.S. have
experienced at least one major trauma
(extreme stressor) in their lives…
– Examples:
 serious accident/natural disaster
 rape or criminal assault
 combat exposure
 child sexual or physical abuse and/or
severe neglect
 hostage/imprisonment/ torture
 sudden unexpected death of a loved one
PTSD

Five factors are necessary for diagnosis:
– The person must have experienced or
witnessed an extreme stressor
– Re-experiencing of the traumatic event
– Avoidance and emotional numbing
– Increased arousal
– Set of symptoms that have lasted at least one
month
Significant Life Changes

Change itself may cause stress by forcing
us to adapt to new circumstances
– Is change, positive or negative, necessarily
harmful?
 No support that positive “stressors” are as harmful
as negative stressors
 Impact of change depends on person and how
change is interpreted
The Hassles of Everyday Life

Most common source of stress arises from
the daily hassles that irritate us
– Ex: Environmental factors

“Microstressors” place a constant strain
on us
– The accumulation of daily hassles contributes
more to illness than do major life events
Dormitory Life

Baum & Valins (1977)
– These researchers compared two layouts of
dormitory in university residences…
 One was based on a long corridor design, with 17
rooms opening off a single corridor, whereas the other
was a suite of three rooms opening off a communal
area
 The total space per student was about the same in
the two designs and the facilities were similar, but
student s in the long corridor style residence
complained more about being crowded and about
having to avoid unwanted social contact
 They withdrew from social contact even when they
were away from the residence
Dormitory Life

Baum & Valins
(1977)
– Traditional
dorms appear
to be more
stressful than
newer suite
style
They demolished this dorm…

In one case, a 26 floor, 1,300 student
residence, Sander Hall, was demolished at
the University of Cincinnati in 1991
because of persistent problems of violence
and vandalism
Karlin et al. (1979)

Students who are accommodated 3 to a
room intended for 2 suffer less
contentment and lower grades
Watch your Blood Pressure…

Evans (1979)
– Compared ten person groups of people
– Some were in rooms 20 x 30 feet, while
others were in rooms 8 by 12 feet
 Results:
–The people packed into small rooms had
higher pulse rates and blood pressure
Is noise stressful???

Research indicates that living in a busy
city, near a highway, airport, etc. can have
detrimental effects
How Does Stress Affect the Body?

Selye (1976)
– His General Adaptation Syndrome model
illustrates the effects of stress
– Selye felt that the body’s adaptive response to
stress was very general – like a burglar alarm
that would sound off no matter what intruded
– His model has three overlapping stages alarm, resistance, and exhaustion
The General
Adaptation Syndrome
Phase 1: Alarm Reaction


Alarm reaction caused by a sudden activation of your
sympathetic nervous system (this is the part of the
autonomous nervous system that arouses the body
(increases HR, BP, etc.)
Mobilizes energy in stressful situations
– So, your body recognizes danger and mobilizes for a
"fight-or-flight" situation…
 System is activated but since you are in temporary
shock – your resistance drops below normal –
usually minor and short-term
 Therefore, the person may show various
symptoms of stress -- headaches, fever, fatigue,
sore muscles, shortness of breath, diarrhea, upset
stomach, etc.
Phase 2: Resistance
Time to fight the challenge
Your body responds to the challenge with an outpouring of
stress hormones causing your temperature, blood pressure,
heart rate, and respiration all remain high
 Everything is in full force to help you cope with the stressors
 As body defenses stabilize, the symptoms of alarm seem to
disappear
 The adjustment to stress and the outward appearance of
normality are maintained at high cost…
– During this resistance stage, the body is more able to
cope with the original stress
– However, its resistance to any other stress is lowered

Phase 3: Exhaustion

During this phase, the individual reservoir
of resources is becoming depleted
– The person is especially vulnerable to
diseases and in extreme cases collapse and
death (immune system is being challenged by
the long-term stress)
 Example: Heart attack
What Stress Does to the Heart

Type A Behavior Pattern:
– Characterized by extremes of competitive
striving for achievement, a sense of time
urgency, hostility, and aggression
– A risk factor for coronary heart disease
(CHD)?
– Hostility appears to be the main toxic
ingredient in CHD
How “Hostile” Is Your Pattern of
Behavior?
From Anger Kills: 17 Strategies by Redford B. Williams, M.D., and Virginia Williams, Ph.D. Used
by permission of Prentice-Hall, Inc., Upper Saddle River, NJ.
Specific Types of Personalities…

Friedman & Rosenman (1959)
– Summarized years of research to come up
with the much publicized Type A and Type B
personalities
Type A

Has a chronic sense of time urgency
– Rushed and hurried, this person is always "on edge"

Has quick and abrupt speech
– Often interrupting others

Is very competitive
– Even in noncompetitive situations
Is a hard-driving, achievement-oriented, and
status-conscious person
 Frequently becomes hostile and aggressive

Type B

This person has an easier-going
lifestyle
– Is much more able to sit back and relax
Less competitive
 More understanding and forgiving
 Enjoy leisure and weekends more

Some Differences…
The most important difference is that Type
A men are 2-3 times more likely to suffer
angina, heart attacks, or sudden death
than type B men
 Type A smoke more, sleep less, drink
more coffee, walk faster, work later, drink
less milk, etc.

Situational difference here as well…
Interestingly, in relaxed situations, HR, BP,
hormonal secretions, etc. are very similar…
 But when harassed…watch out…

– Given a difficult challenge, threatened with loss of
freedom or control we see big differences…
 Type A’s are much more physiologically reactive as
HR, BP, hormonal secretions, etc. -- SOAR!
 Type B’s remain at moderate levels
– Example: Williams (1989)
 Subjects asked to do simple math problems
 Type A’s stress-hormone levels rose to more
than double the Type B’s
Why Is Hostility and CHD Linked?
Cardiovascular system becomes
overworked
 Hostile people are less health conscious
 Hostile people are physiologically reactive

– In tense social situations they exhibit more
intense cardiovascular reactions
What Stress Does to the
Immune System
Stress compromises the body’s immune
system
 Psychoneuroimmunology (PNI): A subfield
of psychology that examines the links
among psychological factors, the brain
and nervous system, and the immune
system

Stress and the Immune System

The immune system is the body’s first line of
defense against invading substances and
microorganisms
– Stress can impair or suppress the immune system

Social support and other stress-mediating
factors can help sustain one’s immune system
– Social support may prevent illness by providing an
outlet for the person under stress
Social Support

Quality of social support can influence one’s
ability to cope with stress…
– Those who have close relationships with friends,
relatives, religious organizations, self-help groups,
etc. usually benefit and can be helped through a
tough time
– This type of support is crucial for trauma victims
 Posttraumatic Stress Disorder

Having too much support or the wrong kind of
support can be as bad as not having enough
support
– How can this be?
Effects of Severe Stress…

Occurs when demands are too intense for
our coping techniques (or if we perceive
them to be too intense)…
– Lowering of Adaptive Efficiency
– “Wear and Tear”
Lowering of Adaptive Efficiency

Physiological Level
– Severe stress can impair the body’s ability to fight off invading
bacteria and viruses
– We get the flu
Psychological Level
– Makes it difficult or impossible for an individual to see a situation
objectively or to perceive the alternatives that are actually
available
– Suicide attempts

When we use all our resources to combat one severe stressor, we
have less of a tolerance for others

“Wear and Tear”

After we are exposed to a stressful
experience, can rest completely restore us
to normal levels of functioning?
– Selye (1976): says no
 Indelible scar is left
 Every period of stress adds up
Stress and the common cold…

Cohen (1993)
– The participants supplied information about three
things:
 Numbers of negative life events they had
experienced in the last 12 months
 Perceived stress. A questionnaire measure of how
unpredictable, uncontrollable and overloading the
individuals found their lives
 Negative emotions. Ratings of the extent to which
they had felt 15 emotions over the last week;
distressed, nervous, sad, angry, dissatisfied with
self, calm, guilty, scared, angry at self, upset,
irritated, depressed, hostile, shaky and content
Cohen (1993)

The volunteers were then exposed to common
cold viruses. Two types of outcome were
examined:
– Infection. Detection of the virus or a significant rise
in levels of virus-specific antibodies in nasal samples
2- 6 days after exposure. (It is possible to be infected
without becoming ill.)
– Clinical colds. A clinician's judgment of cold severity
based on symptom checklists, body temperature, and
numbers of tissues used per day.
Cohen (1993)
Overall, 82% became infected and 46%
developed colds (symptoms)
 Important findings:

– High stress participants: 53% developed colds
– Low stress participants: 40% developed colds
Perceived stress and negative affect were
associated with infection
 Stressful life events were associated with
development of clinical colds, given infection.

Cohen (1998):
Stress Duration and Illness
Attributional and Explanatory Styles

Seligman (1975):
– Depression results
from learned
helplessness

Abramson et al.
(1989):
– Depression is a state
of hopelessness
brought on by the
negative selfattributions people
make for failure.
– Depressive
explanatory style
Hardiness Personality Style

Individuals exhibit three characteristics:
– Commitment
– Challenge
– Control

Hardiness serves as a buffer against stress
– Perception of control is most important factor
Perception of Control
The expectation that our behaviors can
produce satisfying outcomes.
 Self-efficacy: Feelings of competence

– A state of mind that varies from one specific
task and situation to another.
Optimism and Hope

Optimism is a generalized tendency to
expect positive outcomes
– Characterized by a nondepressive explanatory
style

Health can spring from optimism, as
evident by the placebo effect
Pollyanna’s Health

Positive thinking cannot guarantee good
health
– Victims of illness do not just have a “bad
attitude”

Limits to positive thinking…
– Especially if it leads us to see ourselves and
events in ways that are not realistic
Coping Strategies
Problem-focused coping
 Emotion-focused coping
 Proactive coping

Problem-Focused Coping

In dealing with essential tasks, it is better
to confront and control than to avoid
Problem-Focused Coping Stages

Assessment
– Identify the sources and effects of stress

Goal Setting
– List the stressors and stress responses to be
addressed
– Designate which stressors are and are not changeable

Planning
– List the specific steps to be taken to cope with stress
Problem-Focused Coping Stages

Action
– Implement coping plans

Evaluation
– Determine the changes in stressors and stress
responses that have occurred as a result of
coping methods

Adjustment
– Alter coping methods to improve results, if
necessary
Problem-Focused might not always a
beneficial approach???

Why?
– Can be physiologically taxing
– Can lead to development of an overcontrolling, stress-inducing Type A pattern of
behavior
Emotion-Focused Coping:
Shutting Down
One way to react to stress is by shutting down
and trying to deny or suppress the unpleasant
thoughts and feelings
 Distraction can be an adaptive form of avoidance
coping
 Concealing one’s innermost thoughts and
feelings can be physiologically taxing
– Sometimes can lead to “ironic
processes”
 See next slide 

“Try not to think of that little white bear”

Wegner (1994)
– People just couldn’t keep that image from
popping into their head
– The harder they tried the more difficult it
became
Emotion-Focused Coping:
Opening Up

Two aspects to opening up as an
emotional means for coping with stress:
– One must acknowledge and understand one’s
emotional reactions to important events
– One must express those inner feelings to
themselves and others

Why might opening up be helpful?
– Cathartic experience?
– Helps to gain insight into the problem?
Proactive Coping: Social
Support

The helpful coping resources provided by
friends and other people
– Has therapeutic effects on both our
psychological and physical health

Social support and contact related to
longevity
Being Popular…
• Hamrick, Cohen, and Rodriguez
(2002)
• For those under low stress, social connections
didn’t matter (no differences)
• For those under high stress it did (those with
more social connections got sick more often)
• See next slide 
Being Popular doesn’t always
Promote Health
Hamrick, N.S. Cohen, and M.S.Rodriguez (2002)
How Should Social Support Be
Defined?

Simple social contact model
– How many social contacts does a person
have?

Intimacy model
– Does the person have a close relationship
with a significant other?

Perceived availability
– Does the person believe that ample support is
available when needed?
Social Support:
The Religious Connection

Religion provides an important source of
social and emotional support for many
– Only 15-20% of world’s population have no
religious affiliation

There appears to be a link between
religiosity and health?
– Religious individuals tend to outlive their nonreligious counterparts…
 But be careful…
Maybe, its time to get on that
stair climber again…
Many recent studies indicate that aerobic
exercise (exercise that increases heart and
lung fitness) can help reduce stress
 McCann and Holmes (1984)

– Mildly depressed female college students
 Group 1: Aerobic exercise
 Group 2: Relaxation exercise
 Group 3: No treatment
– After 10 week program, the clearly the best
results were reported by those in Group 1
Treatment:
The “Social” Ingredients
All healers provide social support
 All therapies offer a ray of hope

– All therapies communicate and instill positive
expectations

Patients can make meaningful choices
about the treatment
Prevention

Getting the message across that some
behaviors are very unhealthy
– Ex: AIDS, smoking, etc
 Fear appeals
 Use of celebrities
Aiming for Good Health
Subjective Well-Being
One’s happiness, or life satisfaction, as
measured by self-report
 In self-reports, 75% of American adults
describe themselves as happy
 What predicts happiness?

– Social relationships
– Employment status
– Physical health
Income doesn’t seem to matter much…

Increase in income does not lead to increase in
subjective well being
– Most people define themselves as being happy or
not happy, regardless of their material wealth
Why Doesn’t Money Contribute
More to Subjective Well-Being?

Perceptions of wealth are not absolute but
relative to certain standards
– Social comparison theory revisited

People use their own recent past as a
basis of comparison
– Adaptation-level theory
Adaptation-Level Phenomenon
This is our tendency to judge various stimuli
relative to those we have previously experienced
 Whatever it is that's going on in our life, we
immediately adapt to it and then that becomes
neutral
 So if you get a big promotion and raise, you'll think
that's wonderful -- for probably a few weeks, and
then it becomes neutral... and eventually not
enough

– What once gave pleasure such as a raise in salary, loses
its effect
Campbell (1975)

He felt there was no such thing as an
emotional utopia…
– Well, maybe for awhile but the adaptation
principle prevents this from being long-term
 For example: million-dollar lottery winners
return to their earlier level of happiness
Who is happier…Silver medallists or
bronze medallists?

Our feelings are influenced strongly be how we
appraise our situations…
– Medvec, Madey, & Gilovich (1995)
 These researchers analyzed films from
1992 Olympics, and found that athletes
who won Bronze medals were happier than
those who won Silver medals
A Set Baseline Level of
Happiness?

Personality more important than the
situation???
– Ratings of happiness are higher among
identical twins than among fraternal twins
 Suggests a genetic link
– Fluctuations in mood that accompany positive
and negative life events wear off over time
– Happiness levels are relatively stable over
time and place
Do you feel any differently now than
you did 15 weeks ago?
We’ve discussed a variety of situational
influences…
 We’ve also looked at personality and how
it interacts with the situation…


What's more influential insofar as
prediction of a person’s behavior is
concerned?