Chapter 13 Health, Stress, and Coping

Health Psychology

• Uses behavioral principles to prevent illness and death, and promote health

• Behavioral medicine: Applies psychology to manage medical problems (e.g., asthma and diabetes)

• Lifestyle diseases: Diseases related to health-damaging personal habits (e.g., strokes and lung cancer)

Behavioral Risk Factors

• Actions that increase the chances of disease, injury, or premature death

• Disease-prone personality: Personality type associated with poor health; person tends to be chronically depressed, anxious, hostile, and frequently ill

Ways to Promote Health and Early Prevention

• Refusal skills training: Program that teaches young people how to resist pressures to begin smoking (can also be applied to other drugs)

• Life skills training: Teaches stress reduction, self-protection, decision making, self-control, and social skills

Community Health Campaign

• Community-wide education program that provides information about how to decrease risk factors and promote health

• More Ways to Promote Health• Role model: Person who serves as a positive

example of good and desirable behavior• Wellness: Positive state of good health and

well-being; more than the absence of disease

General Adaptation Syndrome (GAS, Selye)

• Series of bodily reactions to prolonged stress; occurs in three stages:

• Alarm Reaction• Body resources are mobilized to cope with

added stress• Stage of Resistance Body adjusts to stress

but at a high physical cost; resistance to other stressors is lowered

• Stage of Exhaustion Body’s resources are drained and stress hormones are depleted, possibly resulting in psychosomatic disease, loss of health, or complete collapse

Stress

• Stress: Mental and physical condition that occurs when a person must adjust or adapt to the environment– Includes marital and financial problems– Eustress: Good stress

• Stress reaction: Physical reaction to stress– Autonomic nervous system is aroused

Stressor

• Condition or event in environment that challenges or threatens the person

• Pressure: When a person must meet urgent external demands or expectations

Immunity

• Immune system: Mobilizes bodily defenses, like white blood cells, against invading microbes and other diseases

• Psychoneuroimmunology: Study of connections among behavior, stress, disease, and immune system

Stress Management

• Use of cognitive behavioral strategies to reduce stress and improve coping skills

• Progressive relaxation: Produces deep relaxation throughout the body by tightening all muscles in an area and then relaxing them

• Guided imagery: Visualizing images that are calming, relaxing, or beneficial in other ways

Avoiding Upsetting Thoughts

• Stress inoculation: Using positive coping statements internally to control fear and anxiety– Designed to combat negative self-

statements (self-critical thoughts that increase anxiety and lower performance)

• Coping statements: Reassuring, self-enhancing statements used to stop self-critical thinking

Fig. 13-9, p. 455

Signs and Symptoms of Ongoing Stress

• Emotional signs: Anxiety, apathy, irritability, mental fatigue

• Behavioral signs: Avoidance of responsibilities and relationships, extreme or self-destructive behavior, self-neglect, poor judgment

• Physical signs: Excessive worry about illness, frequent illness, overuse of medicines

Burnout

• Job-related condition (usually in helping professions) of physical, mental, and emotional exhaustion; has three aspects:– Emotional exhaustion: Feel “used up” and

apathetic toward work– Cynicism: Detachment from the job– Feeling of reduced personal

accomplishment

Appraising Stressors

• Primary appraisal: Deciding if a situation is relevant or irrelevant, positive or threatening

• Secondary appraisal: Assess resources and decide how to cope with a threat or challenge

• Perceived lack of control is just as threatening as an actual lack of control

APPRAISAL

Ask students to interview each other, making a list of activities found to be “boring,” “relaxing,” “fun,” and “stressful.”

Most likely, many activities will be listed in different categories by different people. Discuss perceptual differences in primary appraisal

Table 13-3, p. 433

Fig. 13-3, p. 434

Threats

• Emotion-focused coping: Trying to control one’s emotional reactions to the situation

• Problem-focused coping: Managing or remedying the distressing situation

• Traumatic stresses: Extreme events that cause psychological injury or intense emotional pain

Frustration

• Negative emotional state that occurs when one is prevented from reaching desired goals

• External frustration: Based on external conditions that impede progress toward a goal

• Personal frustration: Caused by personal characteristics that impede progress toward a goal

Reactions to Frustration

• Aggression: Any response made with the intention of harming a person, animal, or object

• Displaced aggression: Redirecting aggression to a target other than the source of one’s frustration– Targets tend to be safer, less likely to

retaliate• Scapegoating: Blaming a person or group for

conditions they did not create; the scapegoat is a habitual target of displaced aggression

Reactions to Frustration (cont)

• Escape: May mean actually leaving a source of frustration (dropping out of school) or psychologically escaping (apathy)

• Conflict: Stressful condition that occurs when a person must choose between contradictory needs, desires, motives, or demands

FRUSTRATION AND VIOLENCE

In recent years, there has been an epidemic of kids killing kids. In what ways might frustration have led to many of these acts of violence?

How might children be taught to manage their frustration in ways other than lashing out violently (and often fatally) at their peers?

Fig. 13-4, p. 436

Frustration and common reactions to it.

Conflicts

Approach-Approach Conflicts

• Having to choose between two desirable or positive alternatives (e.g., choosing between a new BMW or Mercedes)

Avoidance-Avoidance Conflicts

• Being forced to choose between two negative or undesirable alternatives (e.g., choosing between going to the doctor or contracting cancer)– NOT choosing may be impossible or

undesirable

Approach-Avoidance Conflicts

• Being attracted (drawn to) and repelled by the same goal or activity; attraction keeps person in the situation, but negative aspects can cause distress

Ambivalence

• Mixed positive and negative feelings; central characteristic of approach-avoidance conflicts

• Can also be simultaneous attraction and repulsion

Fig. 13-5, p. 438

Three basic forms of conflict. For this woman, choosing between pie and ice cream is a minor approach-approach conflict; deciding whether to take a job that will require weekend work is an approach-avoidance conflict; and choosing between paying higher rent and moving is an avoidance-avoidance conflict.

Multiple Conflicts

• Double approach-avoidance conflicts: Each alternative has both positive and negative qualities

• Vacillation: When one is attracted to both choices; seeing the positives and negatives of both choices and going back and forth before deciding, if deciding at all

• Multiple approach-avoidance conflicts: When several alternatives have positive and negative features

What might come up in facing a conflict?Anxiety

• Feelings of tension, uneasiness, apprehension, worry, and vulnerability – We are motivated to avoid experiencing

anxiety

Freudian Ego Defense Mechanisms

• Habitual and unconscious mental processes designed to reduce anxiety– Work by avoiding, denying, or distorting

sources of threat or anxiety– If used in the short term, can help us get

through everyday situations– If used in the long term, we may end up not

living in reality

Freudian Ego Defense Mechanisms: Some Examples

• Denial: Most primitive; refusing to accept or believe reality; usually occurs with death and illness

• Repression: When painful memories, anxieties, and so on are unconsciously held out of our awareness

• Reaction formation: Impulses are repressed and the opposite behavior is exaggerated

More Freudian Ego Defense Mechanisms

• Projection: When one’s own feelings, shortcomings, or unacceptable traits and impulses are seen in others; exaggerating negative traits in others lowers anxiety

• Rationalization: Justifying personal actions by giving “rational” but false reasons for them

DISPLACED AGGRESSION

Think of someone you are mad at or frustrated with. Then, either draw or write something that represents them on a piece of paper, and when I say GO, tear it up into small pieces.

Do you feel better about the conflict situation?

Table 13-4, p. 441

Learned Helplessness (Seligman)

• Acquired (learned) inability to overcome obstacles and avoid aversive stimuli; learned passivity– Occurs when events appear to be

uncontrollable– May feel helpless if failure is attributed to

lasting, general factors

Fig. 13-7, p. 443

In the normal course of escape and avoidance learning, a light dims shortly before the floor is electrified (a). Because the light does not yet have meaning for the dog, the dog receives a shock (noninjurious, by the way) and leaps the barrier (b). Dogs soon learn to watch for the dimming of the light (c) and to jump before receiving a shock (d). Dogs made to feel “helpless” rarely even learn to escape shock, much less to avoid it.

Apply this to humans. In what ways can we learn to be helpless?

Depression

• State of despondency defined by feelings of powerlessness and hopelessness– One of the most common mental problems

in the world– Childhood depression is dramatically

increasing– Some symptoms: Loss of appetite or sex

drive, decreased activity, sleeping too much

Mastery Training

• Responses are reinforced that lead to mastery of a threat or control over one’s environment– One method to combat learned

helplessness and depression

How to Recognize Depression (Beck)

• You have a consistently negative opinion of yourself

• You engage in frequent self-criticism and self-blame

• You place negative interpretations on events that usually would not bother you

• The future looks grim• You can’t handle your responsibilities and

feel overwhelmed

Stress and Health

• Social Readjustment Rating Scale (SRRS): Rates the impact of various life events on the likelihood of contracting illness– Not a foolproof method of rating stress– Are positive life events (getting married,

having a child) always stressful?– People also differ in their reactions to

stress

Microstressors (Hassles)

• Any distressing day-to-day annoyance• Acculturative Stress Caused by many

changes and adaptations required when a person moves to a foreign culture

Psychosomatic Disorders

• Psychological factors contribute to actual illnesses (bodily damage) or to damaging changes in bodily functioning

• Hypochondriacs: Complain about diseases that appear to be imaginary– Certain kinds of ulcers are not

psychosomatic– Most common complaints: respiratory and

gastrointestinal

Biofeedback

• Applying informational feedback to bodily control– Aids voluntary regulation of activities such

as blood pressure, heart rate, and so on– Helpful but not an instant cure– May help relieve muscle-tension

headaches, migraine headaches, and chronic pain

Cardiac Personalities

• Type A personality: Personality type with elevated risk of heart disease; characterized by time urgency and chronic anger or hostility

• Anger may be the key factor of this behavior

• Type B personality: All types other than Type As; unlikely to have a heart attack

Hardy Personality• Personality type associated with superior stress resistance

– Sense of personal commitment to self and family– Feel they have control over their lives– See life as a series of challenges, not threats– What cultural values would encourage Type A behavior?

Type B behavior? More hardy personalities? Why?

Put students in groups of six. One person stands in the middle, and the other five put their arms around the waists of the people on either side. The person in the middle has five minutes to break out of the circle. Count backwards for the final 30 seconds.

Did you see students increase the vigor of their attempts during the last few seconds?

Caution students against expressing their frustration aggressively.