Stress and Illness – Chapter 10

What is stress according to Lazarus and Launier?

1. person-environment fit (good or poor)

2. appraisal of the event and of personal resources

Consequences of stress on heath for society (+reduction)

1. serious adverse effects on physical and mental health

2. differences in exposure to stress leads to health inequalities across genders, cultures, SES (minority groups harmed by discrimination)

3. effects of stressors on health are reduced with high mastery, self confidence, and social support

Good vs bad stress

1. distress is harmful and draining, eustress is positive and energizing

2. acute stress is more beneficial than chronic stress

Life events theory of stress

1. stress is a response to life events, the more an event causes a person to change their lives the more stress

2. health related life events strongly predict mortality

3. neglects stressors that marginalized groups experience

Moderators of stress/illness link

1. physiological moderators

2. TMS (appraisal)

3. direct pathway (physiology)

4. indirect pathway (behavior)

Moderators of stress/illness link: physiological moderators

1. stress reactivity: the extent to which the same level of stressor causes sympathetic activation

2. stress recovery: rate of recovery to baseline

3. allostatic load: wear and tear on the body accumulated over chronic stress

Moderators of stress/illness link: Transactional Model of Stress

1. primary appraisal (external event): irrelevant, benign and positive, negative and a threat, negative and a challenge

2. secondary appraisal (individual): evaluating pros and cons of coping strategies

3. stress response: direct action, info seeking, doing nothing, developing means of coping (relaxation/defense)

4. most stressful: salient ambiguous or uncontrollable events, overload

Moderators of stress/illness link: Direct Pathway

1. sympathetic activation: release of adrenalin and noradrenalin (heart rate, blood pressure, sweating, pupil dilation, immune function)

2. HPA activation: release of cortisol (management of carbohydrate stores, inflammation, immune function)

Moderators of stress/illness link: Indirect Pathway

1. smoking initiation, relapse, amount: children changing schools more likely to start smoking 

2. alcohol tension-reduction theory: drinkers drink more when they perceive stress, more stress is associated with less consumption in women but higher SUD in men

3. eating stress eating paradox: stress can case over and undereating 

4. exercise: bidirectional relationship where stress reduces exercise and exercise reduces stress 

5. accidents: stress increases tendency to perform behaviors that increase chance of being injured

Chronic/Acute Stress Model

1. chronic stress (HPA, cortisol): ongoing wear and tear, atherosclerosis, cardiovascular damage

2. acute stress (sympathetic activation): changes to heart rate and blood pressure, sudden changes like heart attack

Appraisal non necessity in repressors – TSM weakness

1. repressors deny or repress emotional response to a stressor through selective inattention or forgetting

2. show incongruence between physiological state and reported anxiety

3. appraisal is not always needed to elicit stress

Coping as a moderator of stress

adaptive coping is a buffer and maladaptive coping is a risk factor

Effective coping

1. reduces intensity and duration of the stressor

2. reduces likelihood that stress will lead to illness, minimizes negative outcomes

Coping styles

1. approach: confront problem, gather info, take direct action

2. avoidance: minimizing importance of the event

3. effectiveness depends on the stressor, avoidance works for short term

4. work and young age linked to problem focused coping, relationships and old age linked to emotion focused coping

Appraisal focused coping

modifying how one thinks about the stressor (denial, humor, distancing)

Emotion focused coping

changing emotional reaction to a stressor (letting it out, distraction, social support)

Problem focused coping

reducing the demands of the stressor or increasing the resources to deal with it (taking control, seeking info, plan making)

Coping and the stress-illness link

1. problem solving and acceptance styles of coping associated with more stress reduction for carers of patients with dementia 

2. baseline avoidance coping associated with more chronic and acute life stressors 4 years later and more depressive symptoms 10 years later

Coping and positive outcomes

1. benefit finding

2. growth oriented functioning and crisis growth

3. seems helpful if meaning is found

Role of social support in stress

1. physical benefits

2. behavior promotion

Role of social support: physical benefits

1. enhanced immune response to stress

2. hugging and social support predicted less severe illness signs after cold virus

Role of social support: behavior promotion

1. more confidence

2. reduced risk behavior 

3. better coping strategies and emotional regulation 

4. moderates genetic and environmental risk factors 

Explanations for why social support reduces stress

1. main effect hypothesis: social support is beneficial in itself, absence is stressful in itself

2. stress buffering hypothesis: social comparison theory, other people enable us to select appropriate coping strategies through comparison

Do your friends stress you out? (Social support and stress study)

1. 6 month longitudinal study of early to midcareer masters students

2. individual stress influenced by that of their network

3. individual influence of network stress increased if peers show same level of stress, and with high neuroticism, low locus of control, and low conscientiousness

4. having more friends leads to more stress

Positive stress

1. stress is only associated with negative effects if one believes stress is harmful for their health

2. acute stress benefits: increase social behavior, improve memory, improve learning