psych ch 13

Stress

Negative emotional state occurring in response to events that are perceived as taxing or
exceeding a person's
resources or ability to cope

Introduction: Stress and Health Psychology

Cognitive Appraisal Model
� Developed by
Richard Lazarus
� Whether we experience stress depends largely on cognitive appraisal of an event and the resources we possess to deal with event

Health Psychology

Studies how biological, behavioral, and social factors influence health, illness, medical treatment, and health-related behaviors

main foci

-How to promote health-enhancing behaviors
-How people respond in the patient-health practitioner relationship
-How people respond to being ill

Sources of Stress: Life Events and Change

� Stressors�events that are perceived as harmful, threatening, or challenging
� Early stress researchers (Holmes and Rahe, 1967) believed any change that required you to adjust your behavior and lifestyle would cause stress
� Developed the Social Readjust

Problems with the SRRS

� Link between SRRS and physical and psychological problems is weak
� Assumes that a given life event will have the same impact on everyone
� Assumes that change in itself, whether good or bad, produces stress
� Most researchers agree that undesirable eve

Traumatic Events

Events or situations that are negative, severe, and far beyond our normal expectations for everyday life or life events

Traumatic Events

� 85% of people report having been exposed to a traumatic event during their lifetime
� When traumas are intense or repeated, some psychologically vulnerable people may develop post-traumatic stress disorder (abbreviated PTSD).
� Fewer than 30% of those w

seery

high and low levels
of cumulative adversity were associated with poor health outcomes

Developing Resilience

� Seery - high and low levels
of cumulative adversity were associated with poor health outcomes
� Experiencing some stress was healthier than experiencing no stress at all
� People who have had to cope with a moderate level of adversity develop resilience

Daily Hassles:
That's Not What I Ordered!

� Everyday minor events that annoy and upset people
� Such ordinary irritations in daily life might be an important source of stress
� Number of daily hassles people experience is a better predictor of physical illness and symptoms than is the number of m

Burnout

an unhealthy condition caused by chronic, prolonged work stress that is characterized by exhaustion, cynicism, and a sense of failure or inadequacy
Causes:
-overload; lack of control
Solution:
-sense of community

three source of a burnout

1. People feel exhausted, as if they've used up all
of their emotional and physical resources
2. People experience feelings of cynicism, demonstrating negative or overly detached attitudes
3. People feel a sense of failure or inadequacy, have a sharply re

Social and Cultural Sources of Stress

� People who live under difficult or unpleasant conditions experience chronic stress.
� Crowding, crime, poverty, and substandard housing
� People in less privileged groups have fewer resources with which to cope with stressors
� Chronic stress is also as

Acculturative stress

Stress that results from the pressure of adapting to a new culture

Reducing stress

� Acculturative stress is reduced when new society accepts ethnic and cultural diversity
� Transition is eased when person has some familiarity with new language and customs, advanced education, and social support from friends, family members, and cultura

Two questions are faced
when entering a new culture:

1. Should I seek positive relations with the dominant society?
2. Is my original cultural identity of value to me, and should I try to maintain it?

Four possible patterns of acculturation

1. integration (low stress)
2. assimilation (moderate stress)
3. marginalization (greatest stress)
4. separation (high stress)

Stress can indirectly affect
a person's health
by prompting behaviors that jeopardize physical well-being, such as not eating or sleeping properly

Stress can directly affect physical health by altering body functions, leading to symptoms of illness or disease

Fight-or-flight response

� Rapidly occurring chain of internal physical reactions that prepare people either to fight or take flight from an immediate threat
� First described by Walter Cannon

Endocrine response

� Threat perceived (amygdala), hypothalamus and lower brain structures activate sympathetic nervous system
� Sympathetic nervous system stimulates adrenal medulla to secrete hormones called catecholamines, including adrenaline and noradrenaline
� Catechol

Hans Selye - Effects of Exposure to Extreme Stress in Rats

� Adrenal glands became enlarged
� Stomach ulcers and loss of weight occurred
� Shrinkage of the thymus gland and lymph glands, two key components of the immune system

Prolonged Stress

� Stress causes pituitary to release ACTH
� ACTH causes adrenals to release corticosteroid (cortisol)
� Short-term reduce inflammation, enhance muscles
� Long-term weaken immune system

General Adaptation Syndrome (GAS)

A three-stage progression of physical changes that occurs when an organism is exposed to intense and prolonged stress

3 stages of GAS

Alarm
� Intense arousal
� Mobilization of physical resources (release of catecholamines)
� Arousal remains above normal
Resistance
� Body actively tries to resist or adjust to the continuing stressful
Exhaustion
� This leads to physical exhaustion and phy

Telomeres

Repeated duplicate DNA sequences that are found at the very tips of chromosomes
� Telomeres protect genetic data in the chromosomes from being broken or scrambled during cell division
� With each cell division, the string of telomeres gets shorter
� Short

Effects of Chronic and Acute Stress on Telomerase Activity

Telomerase is an enzyme that protects and lengthens telomeres. In an experiment by Elissa Epel and her colleagues (2010), telomerase activity was significantly lower in women who were under chronic stress ("caregivers") than it was in a control group of w

Perceived Stress and Telomere Lengt

In a groundbreaking study, psychologist Elissa Epel and her colleagues (2004) compared telomere length in mothers of chronically ill children with mothers of healthy children. Even after controlling for age and other biological factors, telomeres were sig

Immune system

system that produces specialized white blood cells that protect body from viruses, bacteria, and tumor cells

Lymphocytes

specialized white blood cells that fight bacteria, viruses, and other foreign invaders

Psychoneuroimmunology

An interdisciplinary field that studies the interconnections among psychological processes, nervous system, and immune system
� Central nervous system and the immune system are directly linked via sympathetic nervous system
� Surfaces of lymphocytes conta

Stressors that Can Influence the Immune System

� Highly stressful events associated with reduced immune system functioning
� Common stresses can impair immune system
� End or disruption of important interpersonal relationships
� Caring for a family member with Alzheimer's disease
� Marital arguments

Placebo

inactive substance with no known effects

The Mysterious Placebo Effect

� Genuine painkilling drugs and placebos activate the same brain area, called the anterior cingulate cortex
� Anterior cingulate cortex contains many opioid receptors
� Placebo treatment activates opioid receptors in several brain regions associated with

Individual Factors that Influence the Response to Stress: Psychological Factors�Personal Control

� People who can control a stress-producing event often show no more psychological distress or physical arousal than people who are not exposed to the stressor at all
� Rodin and Ellen Langer (1977):
� Nursing-home residents who had opportunities to make

Optimistic Explanatory Style

Use external, unstable, and specific explanations for negative events
Predicts better health outcomes - strong immune system

Pessimistic Explanatory Style

Use internal, stable, and global explanations for negative events
Predicts worse health outcomes

explanatory style: silegman

Explanatory style is relatively stable, especially for negative events

Chronic Negative Emotions

� Strong link between negative emotions and poor health
� People who are habitually anxious, depressed, angry, or hostile are more likely to develop a chronic disease, such as arthritis or heart disease

Positive Emotions

� Associated with increased resistance to infection, decreased illnesses, fewer reports of illness symptoms, less pain, and increased longevity
� Less likely to develop heart disease
� Bring calming and health protective effects to the cardiovascular, end

Type A Behavior and Hostility

Exaggerated sense of time urgency, trying to do more and more in less time
� General sense of hostility, displaying anger and irritation
� Intense ambition and competitiveness
� Hostility component associated with heart disease
� Hostile Type As react mor

Type B

� More easygoing, relaxed, laid back
� Not associated with heart disease

Do Personality Factors Cause Disease?

� Psychologists and other scientists are cautious about the
connections between personality and health
� Many studies are correlational
� Personality factors might indirectly lead to disease via poor health habits
� Disease may influence a person's emotio

social support

Resources provided by other people in times of need

Effects of low social support

� Socially isolated people were twice as likely to die as people with good social relationships
� Chronic loneliness predicts poorer physical and mental health, higher death rates, and decreased cognitive functioning
� More likely have serious health prob

Positive Effect of Diverse Social Networks

� Greater resistance to upper respiratory infections
� Lower incidence of stroke and cardiovascular disease among women in a high-risk group
� Lower incidence of dementia and cognitive loss in old age (Desai & others, 2010)

How Social Support Benefits Health

� Can modify our appraisal of a stressor's significance
� Seems to decrease the intensity of physical reactions to a stressor
� Making us less likely to experience negative emotion
� Direct assistance - money, meals, trips to doctor, referrals

Gender Differences in the Effects of Social Support

MEN
� Men rely on close relationship
with spouse or partner
� Women list close friends along with their spouse as confidant
� Men are particularly vulnerable to social isolation
Risks for Women:
� Women serve as providers of support, which can be stressfu

emotion support

expressions of concern, empathy, and positive regard

Tangible Support

involves direct assistance

Providing Effective Social Support

Effective Strategies:
-Be a good listener and show concern
-Ask questions that encourage the person under stress to express feelings and emotions
-Express understanding about why the person is upset
-Express affection for the person
-Be willing to invest

Coping

Behavioral and cognitive responses used to deal with stressors; involves efforts to change circumstances, or our interpretation of them to make them more favorable and less threatening

Adaptive coping

� Dynamic and complex process
� Involves realistically evaluating situation and determining what can be done to minimize the impact of the stressor
� Adaptive coping also involves dealing with the emotional aspects of the situation

Problem-Focused Coping Strategies

Confrontive coping:
-Uses aggressive or risky tactics
-Ideal if direct and assertive but not hostile
Planful problem solving:
-Rationally analyze situation
-Identify solutions
-Implement solutions
Problem-focused coping:
-Aimed at managing or changing the

Gender Differences in Responding to Stress
"Tend-and-Befriend" or "Fight-or-Flight"?

� Men tend to withdraw
from their families, wanting to be left alone
� Women tend to seek out interactions with their marital partners
� Women likely to seek out and use social support when under stress
Why?
� Tending to offspring in times of stress would

Emotion-Focused Coping Strategies

Coping efforts primarily aimed at relieving or regulating the emotional impact of a stressful situation.

Escape-avoidance

try to escape stressor
� Examples: sleeping, drugs, fantasy, exercising, immersing self in work, hobbies, studies
� Associated with poor adjustment, depression, anxiety

Seeking social suppor

seeking support of other people

Distancing

minimize impact of stressor
-humor
-detached, itellectual, or depersonalized attitude

denial

Refuse to acknowledge problem
-can compound the situation

positive reappraisal

-positive religious coping
-associated with lower stress, better health

negative religious coping

� Anger, question beliefs, think they are being punished
� Can lead to poor health

Individualistic Cultures

� Emphasizes personal autonomy and personal responsibility in dealing with problems
� Emphasize importance and value of exerting control over circumstances � Less likely to seek social support in stressful situations than are members of collectivistic cul

Collectivistic Cultures

� Oriented toward social group, family, or community, and toward seeking help with problems � Greater emphasis is placed on controlling your personal reactions
� More likely to rely on emotional coping strategies than people in individualistic cultures

Minimizing the Effects of Stress

Suggestion 1
Avoid or minimize the use of stimulants.
Suggestion 2
Exercise regularly.
Suggestion 3
Get enough sleep.
Suggestion 4
Practice a relaxation technique.