Stress, Coping, and Health

Chapter 12Stress, Coping, and Health 1Behavioral MedicineAn interdisciplinary field of science that integrates behavioral & medical knowledge & applies it to health & illness

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

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

2What Causes Stress? Stress: our response to events that disturb, or threaten to disturb, our physical or psychological equilibrium

Stressors: external or internal events that challenge or threaten us3StressorsMajor cataclysmic events

Personal major events

Minor stressful events, called hassles

Even positive events can tax bodys resources and cause stress. negative events induce more stress than neutral or positive events. 4Mind, Brain & BodyAt any moment, your brain is creatively performing about 400 billion actions. You are only conscious of around 2000.Dr. Caroline LeafWho Switched Off My Brain?Mind, Brain & BodyDr. Candance Pert

Brain and mind function as a single psychosomatic network.

The crucial link is emotions. Biochemical molecules of emotion are like photocopies of thought.Mind, Brain & BodyThe more you think, the more you understand.The more focused and aware you are, the stronger your memory (dendrites firmly attached).During sleep, your thoughts are sorted out. Glial cells prune dendrites.Mind, Brain & BodyEverything you see, hear, and feel becomes part of your thought life.

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

Mind, Brain & BodyThe thalamus sends an electrical message to the cortex and activates a memory.

Your limbic system is a chemical factory.The amygdala is a library of emotional perceptions to check the memory. It may dominate the cortex.The hippocampus will hold short-term memories for 48-72 hours.The hypothalamus translates the conclusion to a bodily response.Mind, Brain & BodyEmotions are cellular signals that translate information into physical reality.The substances used include peptides, steroids, and neurotransmitters.About 90% of this process is non-conscious and 10% conscious.Hans Selye: Stress as a Set of Responses to DemandsGeneral Adaptation Syndrome (GAS): Hans Selyes stress model in which an event that threatens an organisms well-being (a stressor) leads to a three-stage bodily response:

Stage 1: AlarmStage 2: ResistanceStage 3: Exhaustion

11General Adaptation Syndrome (GAS)

Stage 1: AlarmUpon encountering a stressor, body reacts with fight-or-flight response and sympathetic nervous system is activated. Hormones such as cortisol and adrenalin released into the bloodstream to meet the threat or danger. The bodys resources now mobilized.Stage 2: ResistanceParasympathetic nervous system returns many physiological functions to normal levels while body focuses resources against the stressor. Blood glucose levels remain high, cortisol and adrenalin continue to circulate at elevated levels, but outward appearance of organism seems normal. Body remains on red alert.Stage 3: ExhaustionIf stressor continues beyond bodys capacity, organism exhausts resources and becomes susceptible to disease and death.

12Psychophysiological (Psychosomatic) Illnesses Are Stress Related Psychophysiological disorders: physical conditions, such as high blood pressure and migraine headaches, that are caused or aggravated by psychological factors such as stress

Two bodily systems have received the most attention.

13Psychophysiological Illnesses Are Stress Related The cardiovascular system is strongly affected by stress-related emotional responses

High blood pressure (or hypertension)Instances of ischemiaheart does not receive sufficient bloodThe release of cortisol from the adrenal cortex and epinephrine from the adrenal medulla, which ultimately leads to artery blockage and heart attacks14Psychophysiological Illnesses Are Stress RelatedThe immune system: a complex surveillance system of specialized cells, tissues, and organs (the bodys primary defense against disease) reacts to and destroys cells determined not to be part of the body. Three important types of cells in the immune system are B cells, T cells, and natural killer cells. Both acute and chronic stress can reduce the efficiency of the immune system, making the body more susceptible to disease.15

Cognitive AppraisalRichard Lazarus (early researcher) Cognitive appraisal is essential in defining whether a situation is a threat, how big a threat it is, and what resources you have to deal with the threat. 16While responding, you build your mental framework.You exercise your will to accept or reject information (corpus callosum).Accepted information is amplified.Rejected information will disappear.

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

Cognitive AppraisalLazarus identified two cognitive appraisal stages: (notice fear vs. faith)

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

Secondary appraisal: assess whether you have ability to cope with stressor. The more competent you perceive yourself to be, the less stress you experience. 18Cognitive AppraisalLazaruss model conceives of the person as an active participant in evaluating and responding to stressors.

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

Emotion-focused coping: efforts to manage your emotional reactions to stressors rather than trying to change the stressors themselves 19

Predictability and Control Can Moderate the Stress Response Whether an event becomes a harmful stressor is often determined by:

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

Factors related to control over it; e.g., having faith20

Predictability and Control Can Moderate the Stress Response If you believe that you have some control over a stressor, you usually feel less stressed.

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

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

Repeated failure at trying to eliminate stressors can lead to a feeling of learned helplessness. 21Hostile & Pessimistic Persons Are More Reactive to StressorsType A Behavior Patterncharacterized by competitiveness, impatience, ambition, hostility, & a hard-driving approach to life is associated with increased risk of heart disease

Type B Behavior Patterncharacterized by a patient, relaxed, easygoing approach to life, with little hurry or hostility only half as likely to develop heart disease 22Hostile & Pessimistic Persons Are More Reactive to StressorsPessimistic explanatory style:tendency to explain cause of negative uncontrollable events as ones own stable personal qualities affecting all aspects of lifeAssociated with health problems and premature death

Optimistic explanatory style:tendency to explain cause of uncontrollable negative events as temporary, external factors that do not affect other aspects of ones life Associated with good health and longevity23These Patterns Can Be ChangedDeal with old issuesDont deny emotionsForgiveDe-guilt (make amends; forgive yourself)Question beliefs and assumptionsTalk with somebody you trust

Social Support Has Therapeutic EffectsPeople with more extensive social support networks are happier, have stronger immune systems, and live longer than those who are socially isolated.

25Social Support Has Therapeutic EffectsCommon benefits of social support:

Provides increased knowledge about the stressor Associating with others often provides information about how to understand and emotionally respond to stressful events.

Provides opportunities to simply express our feelings, which can lead to physical benefits26Religious Belief & ParticipationReligious belief & participation lower stressReligious services and activities allow people to assume leadership, teaching rolesPrayer & meditation lower stress and are associated with longevity

Benefits of FaithMeaningful faith related to happiness Religious women had higher self-rated health throughout life (ages 20-94); no association for menStudies have found that religious commitment moderates blood pressureReligious participation related to longer life (42 studies) Health PsychologyPrayer is associated with positive, health-related changesChoose Your ThoughtsDont unnecessarily expose yourself to negative thinkingDont mindlessly take in informationConsciously decide what thoughts to accept or to rejectConsciously decide what thoughts to entertainBe conscious of what you say (especially to yourself)Aerobic Exercise Can Increase Physical & Mental Health Aerobic exercise: sustained exercise that increases heart and lung fitness Has a positive effect on both physical and mental health

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

It is possible to overdo a good thing. 30Relaxation Training Is Effective in Reducing StressMany psychologists recommend relaxation training as an effective stress antidote.

The most basic relaxation technique is progressive relaxation, a stress-reducing technique involving the successive tensing and relaxing of each of the major muscle groups of the body.31