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!!!