Health Psychology: Stress and Moderators of Stress

Definition of Terms

  • Stress: distress   * Physical, psychological, emotional distress
  • Stressor: causes stress
  • Person-Environment Fit: assessment of personal resources vs. environmental demand   * What you have vs what the environment demands from you

Theories of Stress

  • Walter Cannon: Fight or Flight   * Fight: aggressive response to perceived stress   * Flight: withdrawal/distracting activity
  • Freeze and Fawn   * Freeze: similar to withdrawal “deer in the headlights”   * Fawning: giving extra special attention to the point that it seems too much attention     * Over the top response that involves attention to the person who is undergoing stress     * Overreaction from third party point of view     * Exaggerated attention and affection     * Reaction from somebody removed from the stressful situation
  • Hans Selye’s General Adaptation Syndrome   * All stressors produce the same patterns of physiological changes   * 3 Phases     * Alarm: an organism is mobilized to meet the threat     * Resistance: an organism makes an effort to cope with the threat       * Physical confrontation     * Exhaustion: an organism fails to overcome the threat and the resources become depleted   * Criticisms     * Everyone respond to stress the same way     * Not considering that stress is not only an outcome or endpoint
  • S.E. Taylor’s Tend-and-Befriend   * Especially true of women   * “We’re in the same boat” or “i feel better despite the situation because I’m not the only person in the situation”

The Stress Appraisal Process

  • Conscious process but not everybody appraises the situation, they just tend to react

  • Primary Appraisal: Harm, Threat, Challenge   * Harmful: something damaging has already occurred; negative   * Threat: something that may happen in the future; negative   * Challenge: positive connotation; potential to overcome said challenge   * Trying to distinguish between, harm, threat, challenge   * If positive, some people may feel motivated to tackle the challenge   * If negative, withdraw or retreat from the situation

  • Secondary Appraisal: Personal resources and Coping Mechanisms vs. Primary Appraisal of the stressful event   * Evaluate whether you have enough resources and coping mechanisms to cope with something you consider as harm, threat, or challenge   * 3 types of responses     * Cognitive: you talk about your beliefs, value systems; take those into consideration and ask yourself “will this help me cope?”     * Emotional: fear, frustration, anger, irritation, worry, disappointment, anxiety, embarrassment, annoyed, overwhelmed     * Behavioral: panic, vent, rent, cry, confrontation, withdraw

The Physiology of Stress

  • Sympathetic Activation   * Fight or flight   * Preparing your body to confront stressful situations   * Breathing gets more rapid, muscles are primed for action, increased blood flow to the muscles, heart rate goes up, from some people pupils contract
  • HPA Activation (hypothalamic pituitary adrenal)   * Neurotransmitters come into play   * Epinephrine, norepinephrine, serotonin   * sympathetic nervous system and neurotransmitters associated with sympathetic activity: cortisol   * Too much cortisol leads to inflammation in the body     * Cushing syndrome     * Obesity: stress eating, affects insulin production, decreased insulin sensitivity   * Physiological framework is available for it
  • Stress Reactivity   * Effects of long term stress = high levels of cortisol
  • Physiological recovery   * Return to baseline   * Parasympathetic system is responsible for this
  • Allostatic Load   * Body’s response to prolonged exposure to stress   * No definite structures associated with this   * More general than HPA activity

Dimensions of Stressful Events

  • Negative events   * The more negative, the more it will affect us
  • Uncontrollable events   * Acts of God
  • Ambiguous events   * Vague events
  • Overload   * Overload of physical, emotional, psychological stress   * They would perceive that as more stressful than any other event
  • Factors that would influence how you perceive stressful events

Chronic Stress and Health

  • Effects of chronic stress
  • Stress and the workplace
  • Work + Sedentary lifestyle
  • Overload
  • Ambiguity and Role conflict
  • Work + Multiple Roles

Coping with Stress

  • No two people handle stress in the same way.
  • Personality and Coping   * Negative affectivity (Neuroticism): pervasive; anxiety, depression, hostility   * Type D personality: experiences negative emotions yet inhibits the expression of these emotions     * Martyrs: they don’t express their negative emotions   * Disease-prone personality: the psychological distress that often involves depression, anger, hostility and anxiety is at the core of this “personality type”; individual is more prone to “all causes” mortality

Caution!!!

  • Negativity may lead to the false impression of ill health when there is no evidence of such.
  • Negativity = worry, “awareness” of symptoms = new or existing health condition
  • In summary, people who are chronically negative MAY be more likely to get sick on occasion BUT their symptoms MAY or MAY NOT actually be indicative of ill health. 

Coping Resources

  • Optimism   * healthier immune system;    * optimists often seek out social support    * reframe stressful situations in a positive light;    * more active and persistent coping efforts;    * sense of self-control;    * problem-focused coping
  • Self-control vs. Self-efficacy   * Self-control: belief that one can control one’s behavior; can influence one’s environment; can bring about desired outcomes   * Self-efficacy: narrower perception that one can take necessary action/s to obtain specific outcome in a specific situation
  • High self-esteem
  • Ego strength: dependability, trust, and lack of impulsivity
  • Conscientiousness: deal with stress proactively
  • Self-confidence and easy-going disposition
  • Intelligence: street smarts
  • Emotional stability

Resilience

  • Ability to bounce back from negative experiences (emotional and otherwise) and adapt to whatever changes result from stressful experiences.

COPING STYLE

  • Tendency to deal with stressful events in a particular way
  • Similar to personality traits because it is a characterization of how a person behaves in general, yet different from personality traits in that coping style only becomes evident in times of STRESS.

Specific Coping Styles

  • Proactive coping: requires the ability to anticipate and detect stressors, coping skills, and self-regulatory skills (control, direct, correct actions based on whether you end up moving toward or away from your goals).
  • Avoidant coping style vs.  Approach coping style   * Avoidant coping = withdrawal; closest to denial     * Not deal with the stressful situation     * “If I don’t see it, it’s not real”   * Approach coping = meeting/facing problems HEAD ON     * Closest to problem-based coping
  • Problem-focused vs. Emotion-focused coping style: problem-focused coping is attempting to do something constructive about stressful situations; emotion-focused coping may or may not result in beneficial ways of dealing with stress (e.g. ruminating vs. emotional-approach coping)    * Emotion-focused coping = efforts to regulate emotions experienced because of stressful event     * Going by your feelings/emotions   * Emotional approach coping = clarifying, focusing on, and working through emotions brought on by a stressor; results in beneficial effects on stress regulatory systems and helps people AFFIRM important aspects of “the self”/identity

When is coping successful?

  • Reduces harmful environmental conditions
  • Tolerate or adjust to negative events
  • Maintain a positive self-image
  • Maintain emotional equilibrium   * Emotional equilibrium = emotionally stable state
  • Continue satisfying relationships with others
  • Successful coping = Enhances prospects of recovery   * Successful coping = enhanced recovery

Social support

  • Types of social support   * Tangible assistance – material support   * Informational support – education, information   * Emotional support   * Invisible support – “giver” is anonymous
  • Forms of social support   * Confidant   * Marriage   * Support from family   * Support from community
  • Social support is most beneficial when the support that is given MATCHES or is responsive to the needs of the receiver; also beneficial if the “giver” is known to the receiver.

Coping interventions

  • Mindfulness training
  • Expressive writing: eliminates rumination or obsession about negative or traumatic events
  • Relaxation training
  • Time management and planning
  • Assertiveness training
  • Regular exercise: Endorphins! Remember LEGALLY BLONDE!!!

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