Stress, Coping, & Health. Biopsychosocial Model n Physical illness caused by interactions...

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