chapter 12 stress, coping, and health. behavioral medicine an interdisciplinary field of science...

Chapter 12Chapter 12Stress, Coping, and HealthStress, Coping, and Health

Behavioral MedicineBehavioral Medicine

An interdisciplinary field of science that integrates An interdisciplinary field of science that integrates behavioral & medical knowledge & applies it to behavioral & medical knowledge & applies it to health & illnesshealth & illness

Health psychologists study the effects of behavior & Health psychologists study the effects of behavior & mental processes on health & illness.mental processes on health & illness.

Biopsychosocial model: an interdisciplinary model Biopsychosocial model: an interdisciplinary model that assumes that health & wellness is caused by a that assumes that health & wellness is caused by a complex interaction of biological, psychological, and complex interaction of biological, psychological, and sociocultural factors.sociocultural factors.

What Causes Stress?What Causes Stress?

Stress: our response to events that disturb, Stress: our response to events that disturb, or threaten to disturb, our physical or or threaten to disturb, our physical or psychological equilibriumpsychological equilibrium

Stressors: external or internal events that Stressors: external or internal events that challenge or threaten uschallenge or threaten us

StressorsStressors

Major cataclysmic eventsMajor cataclysmic events

Personal major eventsPersonal major events

Minor stressful events, called hasslesMinor stressful events, called hassles

Even positive events can tax body’s Even positive events can tax body’s resources and cause stress.resources and cause stress. – negative events induce more stress than negative events induce more stress than

neutral or positive events. neutral or positive events.

Mind, Brain & BodyMind, Brain & Body

At any moment, your brain is At any moment, your brain is creatively performing about 400 creatively performing about 400 billion actions. You are only billion actions. You are only conscious of around 2000.conscious of around 2000.

Dr. Caroline LeafDr. Caroline Leaf

Who Switched Off My Brain?Who Switched Off My Brain?


Dr. Candance PertDr. Candance Pert

– Brain and mind function as a single Brain and mind function as a single psychosomatic network.psychosomatic network.

– The crucial link is emotions. The crucial link is emotions. Biochemical molecules of emotion are Biochemical molecules of emotion are like “photocopies” of thought.like “photocopies” of thought.


The more you think, the more you The more you think, the more you understand.understand.

The more focused and aware you The more focused and aware you are, the stronger your memory are, the stronger your memory (dendrites firmly attached).(dendrites firmly attached).

During sleep, your thoughts are During sleep, your thoughts are sorted out. Glial cells prune sorted out. Glial cells prune dendrites.dendrites.


Thoughts are brain electro-chemical Thoughts are brain electro-chemical patterns.patterns.– Negative emotions are fear based.Negative emotions are fear based.– Positive emotions are faith based.Positive emotions are faith based.

Everything you see, hear, and feel Everything you see, hear, and feel becomes part of your thought life.becomes part of your thought life.


The thalamus sends an electrical message The thalamus sends an electrical message to the cortex and activates a memory. to the cortex and activates a memory.

Your limbic system is a chemical factory.Your limbic system is a chemical factory.– The amygdala is a library of emotional The amygdala is a library of emotional

perceptions to check the memory. It may perceptions to check the memory. It may dominate the cortex.dominate the cortex.

– The hippocampus will hold short-term The hippocampus will hold short-term memories for 48-72 hours.memories for 48-72 hours.

– The hypothalamus translates the conclusion to The hypothalamus translates the conclusion to a bodily response.a bodily response.


Emotions are cellular signals that Emotions are cellular signals that translate information into physical translate information into physical reality.reality.

The substances used include The substances used include peptides, steroids, and peptides, steroids, and neurotransmitters.neurotransmitters.

About 90% of this process is non-About 90% of this process is non-conscious and 10% conscious.conscious and 10% conscious.

Hans Selye: Stress as a Set of Hans Selye: Stress as a Set of Responses to DemandsResponses to Demands

General Adaptation Syndrome (GAS): Hans Selye’s General Adaptation Syndrome (GAS): Hans Selye’s stress model in which an event that threatens an stress model in which an event that threatens an organism’s well-being (a stressor) leads to a three-organism’s well-being (a stressor) leads to a three-stage bodily response: stage bodily response:

– Stage 1: AlarmStage 1: Alarm

– Stage 2: ResistanceStage 2: Resistance

– Stage 3: ExhaustionStage 3: Exhaustion


General adaptation syndrome General adaptation syndrome (GAS)(GAS)

Stage 1: AlarmStage 1: Alarm– Upon encountering a stressor, body reacts with Upon encountering a stressor, body reacts with

“fight-or-flight” response and sympathetic “fight-or-flight” response and sympathetic nervous system is activated. Hormones such as nervous system is activated. Hormones such as cortisol and adrenalin released into the cortisol and adrenalin released into the bloodstream to meet the threat or danger. The bloodstream to meet the threat or danger. The body’s resources now mobilized.body’s resources now mobilized.


General adaptation syndrome General adaptation syndrome (GAS)(GAS)

Stage 2: ResistanceStage 2: Resistance– Parasympathetic nervous system returns many Parasympathetic nervous system returns many

physiological functions to normal levels while physiological functions to normal levels while body focuses resources against the stressor. body focuses resources against the stressor. Blood glucose levels remain high, cortisol and Blood glucose levels remain high, cortisol and adrenalin continue to circulate at elevated levels, adrenalin continue to circulate at elevated levels, but outward appearance of organism seems but outward appearance of organism seems normal. Body remains on red alert.normal. Body remains on red alert.


General adaptation syndrome (GAS)General adaptation syndrome (GAS)

Stage 3: ExhaustionStage 3: Exhaustion– If stressor continues beyond body’s capacity, If stressor continues beyond body’s capacity,

organism exhausts resources and becomes organism exhausts resources and becomes susceptible to disease and death. susceptible to disease and death.

The General Adaptation SyndromeThe General Adaptation Syndrome

Psychophysiological (Psychosomatic) Psychophysiological (Psychosomatic)

Illnesses Are Stress RelatedIllnesses Are Stress Related

Psychophysiological disorders: physical Psychophysiological disorders: physical conditions, such as high blood pressure conditions, such as high blood pressure and migraine headaches, that are and migraine headaches, that are caused or aggravated by psychological caused or aggravated by psychological factors such as stressfactors such as stress

Two bodily systems have received the Two bodily systems have received the most attention.most attention.

Psychophysiological Illnesses Psychophysiological Illnesses

Are Stress RelatedAre Stress Related The cardiovascular system is sThe cardiovascular system is strongly trongly affected by stress-related emotional affected by stress-related emotional responses responses

– High blood pressure (or hypertension)High blood pressure (or hypertension)– Instances of ischemia—heart does not Instances of ischemia—heart does not

receive sufficient bloodreceive sufficient blood– The release of cortisol from the adrenal The release of cortisol from the adrenal

cortex and epinephrine from the adrenal cortex and epinephrine from the adrenal medulla, which ultimately leads tomedulla, which ultimately leads to artery artery blockage and heart attacksblockage and heart attacks

Psychophysiological Illnesses Psychophysiological Illnesses Are Stress RelatedAre Stress Related

– The immune system: aThe immune system: a complex surveillance complex surveillance system of specialized cells, tissues, and organs system of specialized cells, tissues, and organs (the body’s primary defense against disease) (the body’s primary defense against disease) rreacts to and destroys cells determined not to be eacts to and destroys cells determined not to be part of the body.part of the body.

Three important types of cells in the immune Three important types of cells in the immune system are B cells, T cells, and natural killer system are B cells, T cells, and natural killer cellscells..

Both acute and chronic stress can reduce the Both acute and chronic stress can reduce the efficiency of the immune system, making the efficiency of the immune system, making the body more susceptible to disease.body more susceptible to disease.

Cognitive AppraisalCognitive Appraisal

Richard Lazarus (early researcher) Richard Lazarus (early researcher) Cognitive appraisal is essential in defining Cognitive appraisal is essential in defining whether a situation is a threat, how big a whether a situation is a threat, how big a threat it is, and what resources you have to threat it is, and what resources you have to deal with the threat. deal with the threat.

While responding, you build your mental While responding, you build your mental framework.framework.

You exercise your will to accept or You exercise your will to accept or reject information (corpus callosum).reject information (corpus callosum).– Accepted information is amplified.Accepted information is amplified.– Rejected information will disappear.Rejected information will disappear.

You must feel something is true to You must feel something is true to believe it. Emotions (limbic system) believe it. Emotions (limbic system) tells you what is real, true, and tells you what is real, true, and important.important.

Cognitive AppraisalCognitive AppraisalLazarus identified two cognitive appraisal Lazarus identified two cognitive appraisal

stages:stages: (notice fear vs. faith) (notice fear vs. faith)

– Primary appraisal: initial evaluation of situation; Primary appraisal: initial evaluation of situation; assassess what is happening, whether it is ess what is happening, whether it is threatening, and whether you should take some threatening, and whether you should take some action in response to the threat action in response to the threat

– Secondary appraisal: assess whether you have Secondary appraisal: assess whether you have ability to ability to copecope with stressor. The more with stressor. The more competent you perceive yourself to be, the less competent you perceive yourself to be, the less stress you experience.stress you experience.

Cognitive AppraisalCognitive Appraisal

Lazarus’s model conceives of the person as Lazarus’s model conceives of the person as an active participant in evaluating and an active participant in evaluating and responding to stressors. responding to stressors.

Problem-focused coping: a strategy aimed at Problem-focused coping: a strategy aimed at reducing stress by overcoming the source of reducing stress by overcoming the source of the problemthe problem

Emotion-focused coping: efforts to manage Emotion-focused coping: efforts to manage your emotional reactions to stressors rather your emotional reactions to stressors rather than trying to change the stressors themselves than trying to change the stressors themselves

PPredictability and Control Can Moderate redictability and Control Can Moderate

the Stress Responsethe Stress Response Whether an event becomes a harmful Whether an event becomes a harmful stressor is often determined by:stressor is often determined by:

– It’s predictabilityIt’s predictability

If you know that a stressor is coming but are If you know that a stressor is coming but are uncertain when it will occur, you experience uncertain when it will occur, you experience greater stress. greater stress.

– Factors related to control over it; e.g., Factors related to control over it; e.g., having faithhaving faith

Predictability and Control Can Moderate the Predictability and Control Can Moderate the

Stress ResponseStress Response If you believe that you have some control over a If you believe that you have some control over a stressor, you usually feel less stressedstressor, you usually feel less stressed. .

When you doubt your ability to control a stressor, When you doubt your ability to control a stressor, you are more likely to use emotion-focused coping. you are more likely to use emotion-focused coping.

Locus of control: the degree to which you expect Locus of control: the degree to which you expect that outcomes in your life depend on your own that outcomes in your life depend on your own actions rather than the environment.actions rather than the environment.

Repeated failure at trying to eliminate stressors can Repeated failure at trying to eliminate stressors can lead to a feeling of learned helplessness. lead to a feeling of learned helplessness.

Hostile & Pessimistic Persons Hostile & Pessimistic Persons Are More Reactive to StressorsAre More Reactive to Stressors

Type A Behavior PatternType A Behavior Pattern– characterized by competitiveness, impatience, characterized by competitiveness, impatience,

ambition, hostility, & a hard-driving approach to ambition, hostility, & a hard-driving approach to life is associated with increased risk of heart life is associated with increased risk of heart disease disease

Type B BehaviorType B Behavior P Patternattern– characterized by a patient, relaxed, easygoing characterized by a patient, relaxed, easygoing

approach to life, with little hurry or hostility only approach to life, with little hurry or hostility only half as likely to develop heart disease half as likely to develop heart disease

Hostile & Pessimistic Persons Hostile & Pessimistic Persons Are More Reactive to StressorsAre More Reactive to Stressors

Pessimistic explanatory style:Pessimistic explanatory style:– tendency to explain cause of negative tendency to explain cause of negative

uncontrollable events as one’s own stable uncontrollable events as one’s own stable personal qualities affecting all aspects of lifepersonal qualities affecting all aspects of life

– Associated with health problems and Associated with health problems and premature deathpremature death

Optimistic explanatory style:Optimistic explanatory style:– tendency to explain cause of uncontrollable tendency to explain cause of uncontrollable

negative events as temporary, external factors negative events as temporary, external factors that do not affect other aspects of one’s life that do not affect other aspects of one’s life

– Associated with good health and longevityAssociated with good health and longevity

These Patterns Can Be ChangedThese Patterns Can Be Changed

Deal with old issuesDeal with old issues

Don’t deny emotionsDon’t deny emotions

ForgiveForgive

De-guilt (make amends; forgive De-guilt (make amends; forgive yourself)yourself)

Question beliefs and assumptionsQuestion beliefs and assumptions

Talk with somebody you trustTalk with somebody you trust

Social Support Has Therapeutic Social Support Has Therapeutic EffectsEffects

People with more extensive social People with more extensive social support networks are happier, have support networks are happier, have stronger immune systems, and live stronger immune systems, and live longer than those who are socially longer than those who are socially isolated. isolated.

Social Support Has Therapeutic Social Support Has Therapeutic EffectsEffects

Common benefits of social support:Common benefits of social support:

– Provides increased knowledge about the Provides increased knowledge about the stressor stressor

Associating with others often provides information about Associating with others often provides information about how to understand and emotionally respond to stressful how to understand and emotionally respond to stressful events. events.

– Provides opportunities to simply express Provides opportunities to simply express our feelings, which can lead to physical our feelings, which can lead to physical benefitsbenefits

Choose Your ThoughtsChoose Your Thoughts

Don’t unnecessarily expose yourself to Don’t unnecessarily expose yourself to negative thinkingnegative thinking

Don’t mindlessly take in informationDon’t mindlessly take in information

Consciously decide what thoughts to Consciously decide what thoughts to accept or to rejectaccept or to reject

Consciously decide what thoughts to Consciously decide what thoughts to entertainentertain

Be conscious of what you say (especially Be conscious of what you say (especially to yourself)to yourself)

Aerobic Exercise Can Increase Physical & Aerobic Exercise Can Increase Physical &

Mental HealthMental Health Aerobic exercise: sustained exercise that increases Aerobic exercise: sustained exercise that increases heart and lung fitness heart and lung fitness – Has a positive effect on both physical and mental Has a positive effect on both physical and mental

health health

– Activity that increases heart rate into a certain Activity that increases heart rate into a certain range for at least 12 to 20 minutes fits this range for at least 12 to 20 minutes fits this definition definition

– It is possible to overdo a good thing.It is possible to overdo a good thing.

Relaxation Training Is Effective in Relaxation Training Is Effective in Reducing StressReducing Stress

Many psychologists recommend relaxation training Many psychologists recommend relaxation training as an effective stress antidote. as an effective stress antidote.

The most basic relaxation technique is progressive The most basic relaxation technique is progressive relaxation, arelaxation, a stress-reducing technique involving the stress-reducing technique involving the successive tensing and relaxing of each of the major successive tensing and relaxing of each of the major muscle groups of the body.muscle groups of the body.

chapter 12 stress, coping, and health. behavioral medicine an interdisciplinary field of science...

Documents

health slide

brain body emotions

brain body thoughts

exhaustion slide

positive events

negative events

cause stress

causes stress