Stress & Coping

Nature of Stress

Types of stress can be categorized by how we experience the stimuli emotionally. The four types of stress are:

1. Conflict (ex. Choosing between a dead-end job and the prospect of prolonged unemployment)

2. Frustration (ex. Getting caught in traffic when you are already late.)

3. Change (ex. Graduating from high school, moving, getting married, etc.)

4. Pressure (ex: A notebook check or test are coming up)

Three Responses to Stress

We go through 3 stages of physiological response to stress

• Physiological1. Body experiences an alarm reaction-fight or flight

2. Body adapts to the stress if continual

3. Exhaustion because our body’s resources are being depleted.

Stress and Illness Leading causes of death in the US in 1900

and 2000

Stress and Illness

Stress the process by

which we perceive and respond to certain events, called stressors, that we appraise as threatening or challenging

Three Responses to Stress

• Emotional– Emotions are triggered by the stressor

• Ex. Frustration is likely to bring about anger

Three Responses to Stress

• Behavioral (coping)– The deliberate effort to manage stress by

overcoming it, reducing it, or tolerating it

Folkman & Lazarus (1980)

• Defined coping responses as

‘Cognitions (thoughts) & behaviours that a person used to reduce stress and to moderate it’s emotional impact’

Basically we try to cope with stress and manage it effectively.

Stress & Personalities

Type A Friedman and Rosenman’s term for

competitive, hard-driving, impatient, verbally aggressive, and anger-prone people

Type B Friedman and Rosenman’s term for

easygoing, relaxed people

Promoting Health Modifying Type A life-style can reduce

recurrence of heart attacks

Percentageof patients

with recurrentheart attacks

(cumulativeaverage)

6

5

4

3

2

1

0

Year1978 1979 1980 1981 1982

Life-style modification patients

Control patients

Modifying life-stylereduced recurrent

heart attacks

Ways of Coping Questionnaire (WCQ)

• Ways of Coping Questionnaire: This inventory was used by Lazarus & Folkman to measure a persons coping style. Like the SRRS (Social Skills Rating System) it uses 50 items that are scored on different scales including:

• Social support: Someone to talk to.• Escape avoidance: Hoping for a miracle.• Positive Reappraisal: Changing your

perspective of a problem so it’s less stressful.

WCQ cont….• Two major types of coping strategies were

identified in the results of the WCQ:

• Problem-focused coping- People try to short-circuit negative emotions by taking some action to modify, avoid, or minimize the threatening situation. They change their behavior to deal with the stressful situation

• Emotion-focused coping- People try to directly moderate or eliminate unpleasant emotions. Examples of emotion-focused coping include rethinking the situation in a positive way, relaxation, denial, and wishful thinking.

To understand these strategies, consider the example of a premed student in college who faces three difficult final examinations in a single week. She knows she must get top grades in order to have a chance at acceptance to medical school. This situation is a potential source of stress. To cope, she could organize a study group and master the course materials systematically (problem-focused coping). Or she could decide that she needs to relax and collect herself for an hour or so (emotion-focused coping) before proceeding with an action plan (problem-focused coping). She might also decide to watch television for hours on end to prevent having to think about or study for her exams (emotion-focused coping).

Problem or EmotionFocused Coping?

• John hears a rumor that his girlfriend is cheating on him. John decides to ask her about the rumors.

• John hears a rumor that his girlfriend is cheating on him. John decides to not talk to his girlfriend, because it’s just a rumor.

Problem or EmotionFocused Coping?

• Brittany is failing her first period chemistry class, so she decides to ditch whenever she can.

• Mrs. Dochnahl finds out that Thomas Jefferson had an affair with his slave, Sally Hemings. She rationalizes his betrayal by saying that because it was a different time period, Thomas should be judged by different rules.

Stress Appraisal

Stressful event(tough math test)

Threat(“Yikes! This isbeyond me!”)

Challenge(“I’ve got to apply

all I know”)

Panic, freeze up

Alert, focused

Appraisal Response

Stress and Disease Negative emotions and health-related

consequences

Unhealthy behaviors(smoking, drinking,

poor nutrition and sleep)

Persistent stressorsand negative

emotions

Release of stresshormones

Heartdisease

Immunesuppression

Autonomic nervoussystem effects

(headaches,hypertension)

Life events

Tendency toward

Health Illness

Personal appraisal

Challenge Threat

Personality typeEasy going

NondepressedOptimistic

HostileDepressedPessimistic

Personality habitsNonsmoking

Regular exerciseGood nutrition

SmokingSedentary

Poor nutrition

Level of social support

Close, enduring Lacking

Emotion or problem focused that is the question!!

• Depending on an individuals personality and the stressful situation we all have the potential to use both.

• Research has shown that problem-focused coping is typically used in situations that are perceived to be controllable e.g. work issues. Conversely emotion-based coping is usually used in situations where the stressor is less controllable e.g. Terrorist attacks.

• The most effective strategy is problem-solving if the individual has a realistic chance of changing the stressor or the aspects that lead to the stressor.

What research???

• Health-Outcomes Penley et al (2002) A study of nursing students found problem focused was positively correlated with overall good health whereas emotional focused was negatively correlated with overall good health.

• Control & Coping Park et al (2004) undergraduates described their most stressful event, it’s controllability, how they coped & daily mood. Results again promoted problem focused with more positive outcomes.

• Threat & Coping Rukholm & Viverais (1983) concluded that if a person feels greatly threatened when exposed to a stressor, they need to deal with this using emotion focused coping first. Only then can they make use of the problem-focused techniques.

Is this always the case, problem –focused wins??

• The short answer to this is no. • Fang et al (2006) Studied women who were at

increased risk of hereditary cancer and found those who felt more in control and were actively engaged in problem-based coping actually suffered more in the long term.

• Why??? (highlight below for the answer by changing the font colour to black.).

• Problem-focused coping only effective if it matches reality! There is little a women can do if she is predisposed medically!!!

An overall evaluation.

• Problems of measurement- Like the SRRS there are problems with the scale and what aspect of behaviour is measured under which category.

• Emotion focused-Being portrayed as less effective- This is not always the case Baker & Berenbaum (2007) found those encouraged to express emotions were very effective in dealing with stressors (Men particularly!!).

• Gender differences-(1)Socialisation theory: Women taught to act like young ladies i.e. express your emotions appropriately. Men taught to act like men I.e. express their emotions in a more functional way.

• (2)Constrain theory: The gender differences are the result of social constructs & if placed in similar positions i.e. students, bus drivers etc then they will adopt the same problem solving strategies.

Promoting Health Social support across the life span

12-14 18-19 25-34 45-54 65-74 15-17 20-24 35-44 55-64 75+ Age in years

100%

90

80

70

60

50

Percentagewith high

support

Promoting Health Predictors of mortality

1

0.8

0.6

0.4

0.2

0

Men Women

Not smoking Regular exercise Weekly religious attendance

Relativerisk

of dying

Promoting Health Religious Attendance

Promoting Health Smoking-related early deaths

40,000

30,000

20,000

10,000

0

33,348

1,686 1,135 556 202

Smoking Suicide Vehicle HIV/ Homicide crash AIDS

Cause of death

Numberof deaths

per 100,000

The Physiological Effects of Nicotine

Smoking Prevention

U.S. teen smoking

Obesity and Weight Control

Obesity and body mass index

Obesity and Weight Control

Obesity and mortality

18.5 18.5- 20.5- 22.0- 23.5- 25.0- 26.5- 28.0- 30.0- 32.0- 35.0- 40 20.4 21.9 23.4 24.9 26.4 27.9 29.9 31.9 34.9 39.9

Body-mass index (BM I)Men Women

2.8

2.6

2.4

2.2

2.0

1.8

1.6

1.4

1.2

1.0

0.8

0.6

Relativerisk ofdeath

Weight Control Trading risks

Weight Control

Obesity was more common among those who watched the most television

<2 2-3 >4Hours of television watched per day

in 1990s study

Boys Girls

32

30

28

26

24

22

20

Skinfold fatmeasure (mm)

Weight Control Thinning of Miss America