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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