Stress, Coping, & Health
Biopsychosocial Model
Physical illness caused by interactions between biological, psychological, and sociocultural factors
Biology operates in a psychosocial context
Health Psychology
Focuses on how psychosocial factors relate to promotion and maintenance of health, and the causation, prevention and treatment of illness
Stress
Any circumstances that threaten (real or perceived) one’s well-being, and subsequently tax one’s coping abilities
Subjective in nature (e.g., public speaking, flying, being supervised)
Seriousness of impending surgery unrelated to subjective stress
Types of Stress
1 Frustration2 Conflict3 Change4 Pressure
Frustration
• Occurs in any situation where pursuit of a goal is thwarted
• Can’t get what you want• traffic jams to unrequited love• Unrealistic expectations and frustration
Conflict
Faced with two or more incompatible options, motivations or impulses
Freud Kurt Lewin (1935)
– approach-approach– avoidance-avoidance– approach-avoidance
Conflict
Approach-approach choice between 2 attractive goals win-win situation least stressful
Conflict
Avoidance-avoidance choice between 2 undesirable goals lose-lose quit miserable job vs. unemployment highly stressful
Conflict
Approach-avoidance Choice to pursue a single goal that has
both attractive and undesirable qualities Promotion = pay raise + increased
responsibility produces vacillation - back and forth
behavior, indecision
Change
Any noticeable alterations in life circumstances that require readjustment
not obviously negative events changes in relationships, work,
finances, etc can be stressful, even when welcomed
Change
http://www.cygni.org/scales/social_readjustment_rating_scale.htm
People with higher SRRS more vulnerable to variety of physical ailments than lower scorers
Pressure
Expectations or demands that one behave a certain way
Pressure to succeed at work, to publish, to be cordial, etc
Pressures to conform to expectations of self or others
More strongly related to measures of mental health than SRRS and others
Responses to Stress
Emotional (annoyance, anger) Physiological (racing pulse) Behavioral (yelling, aggression,
avoidance)
Emotional Responses
More likely unpleasant than pleasant Associated with negative mood Dependent on cognitive appraisal Event --> self-blame --> guilt, sadness Common reactions include: annoyance,
anger, ragte, apprehension, anxiety, fear, dejection, sadness, grief, shame, envy, disgust, jealousy
Emotional Responses
Emotional response is motivating (reinforcing, punishing)
Extreme emotional arousal can interfere with coping and performance
Yerkes-Dodson Law (inverted U hypothesis)
optimal arousal dependent on task complexity
Physiological Response
Fight or flight: physiological reaction to threat
autonomic nervous system mobilized for attack or escape
evolutionary value current adaptive value?
General Adaptation Syndrome
Hans Selye noticed that animal physiological
responses to stress were similar regardless of stressor
stress reactions are non-specific coined the term stress
General Adaptation Syndrome
Model of body’s stress response1 Alarm2 Resistance3 Exhaustion
• If stress can’t be overcome, body’s limited coping resources become depleted
• diseases of adaption
Behavioral Responses
Coping: Active efforts to master, reduce, or tolerate demands created by stress
may be positive or negative Individuals exhibit styles of coping that
are consistent across situations
Aggression
Frustration-aggression hypothesis not inevitable context specific displacement catharsis
Self Indulgence
Excessive consummatory behavior shopping, smoking, drinking, eating,
internet
Defensive Coping
Defense mechanisms: unconscious reactions that protect individual from adverse emotions (eg, anxiety, guilt)
shield from stress-eliciting events self-deception, distortion of reality Commonly unhealthy - avoidant
Adaptive/Constructive Coping
Relatively healthful efforts that people make to deal with stressors
1 Confronting problems directly• task relevant• action oriented• rational consideration of options
Adaptive/Constructive Coping
2 Based on realistic appraisal of stress & coping resources
3 Recognizing and inhibiting potentially disruptive emotional reactions
Impact of Stress on Psychology
“Choke” effect Burnout - physical, mental, emotional
exhaustion attributable to longer-term exposure to stressful situations– fatigue, weakness, low energy– negative attitudes towards self, others,
work– hopeless, helpless
Impact of Stress on Psychology
Burnout - need to believe our lives/work are meaningful, and our activities are useful, important, etc
“erosion of the spirit”
Post-traumatic Stress Disorder
Exposure to traumatic event that represented actual or threatened harm, and response involved intense fear, helplessness, or horror
Hyperarousal Intrusive imagery Avoidant behavior
Impact of Stress
Insomnia & sleep disturbance (e.g., nightmares)
poor academic performance sexual problems substance abuse depression & dysthymia
Stress & Physical Health
Psychosomatic disorders: physical ailment with genuine organic basis that are caused in part by psychological factors (emotional distress)
not imagined ailments hypertension, ulcers, migraines, rashes,
asthma
Type A Behavior
1 Highly competitive2 impatient3 angry & hostile
• Type B: easy going, relaxed, amicable• Type A associated with coronary artery,
hypertension, premature mortality
Type A
Double the risk vs. Type B May depend on other individual factors attributable to greater physiological
reactivity ups and downs tax cardiovascular system create more stress for selves less social support & positive coping
Proximal effects of stress
Stress as catalyst for heart attacks Stress management training improves
outcome with cardiac patients Depression and heart disease - cause
or effect? Depression - unhealthy behavior
Psychoneuroimmunology
Arthritis, yeast infections, herpes, dental disease, inflammatory bowel disease
Stress depletes and/or suppresses immune activity - vulnerability to infection
Student research - reduced immune activity surrounding final exams
same for recently divorced men
Stress Moderators
Social Support students reporting greater social
support had higher levels of antibody re: combat respiratory infections
strength of relationship rivals cigarette-cancer relationship
Stress Moderators
Optimism - expectance of positive outcome
related to lower incidence of illness and more effective immune functioning
cope in more adaptive ways pessimists more likely to cope passively pessimism and self-blame
Stress & Health Impairing Behavior Poor nutrition Sedentary lifestyle Substance abuse Smoking