Health stress and coping

1002 - week 8

Health Psychology

Health psychology is devoted to understanding PSYCHOLOGICAL INFLUENCES on how people stay healthy, prevent illness and how they respond to illness.

Biopsychosocial model of health

Biological factors
psychological factors
social factors

Biological factors

Genetic and Predisposition
Age
Gender
Genetics
Tissue Health
Physiologic Reactions

Psychological factors

Cognitive - Attitudes to healthy
Mental Health
Emotional Health
Beliefs and expectations

Social Factors

Environment and others influence in the biopsychosocial model

psychological factors that influence health

health promoting behaviors
health compromising behaviors

health compromising behaviors

eating disordered
alcohol and substance abuse
smoking
unsafe sex behaviors
excessive sun exposure

health promoting behaviors

healthy eating
exercise
health risk screening
dental hygiene
safe sex

health psychology theories

1. Health Belief Model - tanning
2. Theory of Reasoned Action - assumes behaviours are under volitional control
3. Theory of Planned behaviour - red bull and sugar - how much control they have over the behaviour
4. Transtheoretical Model - PCPAM

Health belief model

Perceived susceptibility
Perceived severity
Benefits and barriers to action
Cues to action
Self-efficacy

perceived susceptibility

individuals' perception that they are likely to contract a particular condition

benefits and barriers to action

individuals' evaluations of the benefits and costs to be gained from stopping behavior

cues to action

factors that influence whether or not person is willing to engage in health behaviour

self-efficacy

person's confidence in ability to take action

self-efficacy also has?

protection motivation theory

Theory of reasoned action

evaluation and beliefs of outcome (attitude toward behavior)
the norm beliefs and motivation to comply

all lead to intention and then the behavior

theory of reasoned action

assumes behaviors are under complete volitional control

can I actually perform the target behavior?

theory of planned behaviour

the same as theory of reasoned action but it also has PERCEIVED BEHAVIOURAL CONTROL

this is where the person evaluates whether they can engage in the behavior and control when to stop - sugar example, I can stop anytime.

we perceive we can successfully modify health behaviour

transtheoretical model

precontemplation
contemplation
preparation
action
maintenance

precontemplation

of the transtheoretical model
we may be unaware problem exists
not considering changing behaviour in the near future

contemplation

aware that problem exists
considering taking action soon but not yet fully committed

Preparation

preparing to make behavioural change
making small changes already

action

actively working on behavioural change

maintenance

desired behaviour change achieved
working to maintain this change

transtheoretical model...going back to old ways

relapse

individual Barriers to health promotion

HEALTH COMPROMISING behaviors are more REWARDING in short term AS NEGATIVE effects do not happen immediately as you do not get obese overnight

health promoting is less enjoyable as they're more effortful and take long to occur

beliefs of invincibility
motivated ignorance

health promotion barriers family and social and enviro

family - parent modelling and gate keepers

health system barriers
FOCUS ON TREATMENT RATHER THAN PREVENTION
lack of insurance
doc patient relationship like language barriers
patient expectancies
wait times to see specialists

community, cultural and ethnic barriers
impoverishment
social norms like peers doing it

Stress

stress is a challenge to one's capacity to adapt to inner and outer demands

it threatens or is perceived to threaten one's wellbeing

it is an everyday event

Stress Appraisal

stress is in the eye of the beholder

2 stress appraisals from Lazarus in 1991

Primary Appraisal
is a situation benign, or irrelevant?

Secondary Appraisal
How do I respond to this stress?

Lazarus' 3 types of stress

Harm of loss
Threat
Challenge

Harm or loss

Damage that has already occurred like an accident

threat

a threat of accident or damage/ anticipation of harm or loss

challenge

opportunity for growth

stress sources

change or life events

Social re-adjustment rating scale

Holmes and Rahe
1997
scale measures exposure to life events that are stressful

the most stressful life event

death of a loved one - spouse or child
associated with mortality

Acculturative stress

stress of adapting to a new culture

Catastrophes

Stressors on a mass level which are NATURAL or HUMAN

natural stressors catastrophe

floods and bushfires etc and pandemics

Human catastophe stressors

war
conflict
Associated with harm or loss

Daily hassles

Irritating, frustrating, distressing, everyday demands

coping

active efforts to reduce, tolerate, master the demands of stress
2 types - problem focused coping and emotion focused coping

problem - focused coping

dealing with the stressor (problem itself) itself
efforts to CHANGE the situation
solving this problem is removing the stressor
resolving the situation, seeking advice

emotion - focused coping

dealing with the psychological consequences of the stressor
efforts to alter thoughts
efforts to alter unpleasant emotional consequences of stress
so this is coping with emotion when you cannot remove the stressor

social support with stress

the presence of others in whom you can confide in
and expect help and concern

this is associated with immune functioning and higher mortality and enhanced psychological functioning.

there are 2 hypotheses:
Buffering and Direct-effect

Buffering Hypothesis

stress present - social support acts like a shield D

Direct Effect Hypothesis

less stress to start with due to social support

Optimism in stress

more likely to seek social support
optimism helps regulate stress
you have a more positive appraisal of stressful events
stress is dealt with in more adaptive ways
enhanced immune functioning
puig - perez - diabetes regulation

stress physiology

Fight or Flight from Cannon 1932
Autonomic Nervous System
- mobilizes organism for attacking (fight) and fleeing (flight) and Freeze

Adaptive/Survival purpose

fight or flight - cannon 1932

not so adaptive in the modern world for humans

lengthy stressors leave individuals in a state of enduring physiological arousal

General Adaptation Syndrome - 3 stages of the stress results

Seyle 1956
GAS

3 stages of the stress response:

1. ALARM
2. RESISTANCE
3. EXHAUSTION

stressors are non-specific
all prolonged stressors go through this stage

Alarm - GAS

recognition of the threat and heightened physiological arousal

Resistance

stress continues
physiological changes stabilize as coping begins

Exhaustion if stress is prolonged

Resources are limited
physiological arousal decreases
resistance reduced
can lead to collapse

problems with stress and psychological health

poor academic / occupational performance
burnout
insomnia
sexual difficulties
alcohol/drug abuse

stress psychological disorders

Depression
schizophrenia
eating disorders
anxiety disorders

Post-traumatic stress disorder

An ENDURING psychological disturbance attributed to the experience of a major traumatic event

seen in victims, survivors, witnesses as well as rescue workers

Symptoms: Nightmares, flashbacks, emotional numbing, alienation, disrupted social relations, vulnerability, anxiety, anger, guilt

Type A personality Hostility and Heart disease

Type A personality
strong competitive orientation
impatience and time urgency
anger and hostility

Type B personality

Relaxed
Patient
easy-going
Heart disease accounts for 40 percent of deaths

type A heart disease link

primarily due to anger / hostility
the higher the anger level the higher the risk of a coronary event

immune functioning

Immune response is the body's defensive reaction to invasion by bacteria, viral agents and other foreign substances

stressors such as crowding, shock, lack of food and restraint reduce immune functioning in animals

also, in humans - stress and the common cold

study by cohen et al. 1991 results

high stress participants are more likely to develop infections
stress lowers immune response to disease