BP

Stress, Health, and Coping – Key Vocabulary

Stress and Health Psychology

  • Key Theme
    • Stress emerges when perceived demands exceed perceived coping resources, producing an unpleasant emotional & physical state.
  • Stress (definition)
    • Negative emotional state that arises when events are seen as taxing or exceeding one’s resources.
  • Cognitive Appraisal Model (Richard Lazarus)
    • Stress is not inherent in events but in our appraisal. Two stages:
    • Primary appraisal: “Is this event harmful, threatening, or challenging?”
    • Secondary appraisal: “Do I have the resources to cope?”
    • A re-appraisal loop follows, monitoring coping effectiveness.
    • Example (car won’t start): If resources (bus, friend) are available → no stress; if not → stress.

Health Psychology & the Biopsychosocial Model

  • Health Psychology
    • Investigates how biological, behavioral, & social factors influence health, illness, treatment, & health behaviors.
  • Biopsychosocial Model
    • Illness ≠ purely biological; it results from the dynamic interaction among bio (genetics, physiology), psycho (thoughts, emotions), and social (culture, SES) variables.

Sources of Stress

Life Events & the Social Readjustment Rating Scale (SRRS)

  • Stressors: Events perceived as harmful, threatening, or challenging.
  • Life-events approach (Holmes & Rahe, 1967)
    • Any event requiring significant adjustment → stress, regardless of valence.
  • SRRS assigns “Life-Change Units” (LCUs). Example items:
    • Death of spouse 100, Divorce 73, Christmas 12, Minor law violation 11.
  • Total stress score: \text{Total SRRS Score}=\sum{i=1}^{n} LCUi
  • Scales now revised for gender, marital status, culture.

Traumatic Events

  • Negative, severe, beyond normal life expectations (e.g., war, disaster).
  • Can lead to Post-Traumatic Stress Disorder (PTSD) in vulnerable individuals.

Resilience & Cumulative Adversity

  • Seery et al.:
    • High or low lifetime adversity → poorer health.
    • Moderate adversity fosters resilience (ability to adapt & recover).

Daily Hassles

  • Routine irritations (traffic, lost keys).
  • Number of hassles > number of major events in predicting illness.
  • Gender:
    • Women → friend/family hassles; men → school/work hassles.
  • Sample scales: weight worries, money, computer problems, acculturative hassles for children (pressure to assimilate, language barriers).

Work Stress & Burnout

  • Burnout = chronic work stress → exhaustion, cynicism, sense of failure.
  • Causes: overload & lack of control.
  • Solutions: sense of community; job crafting (proactive redesign of tasks/resources).

Social & Cultural Stressors

  • Low SES → more negative events, hassles, poorer health; perceived low status correlates with higher cold incidence (see bar graph).
  • Racism/Discrimination: overt violence & microaggressions add chronic stress.
  • Acculturative stress when adapting to a new culture: reduced by societal acceptance, language familiarity, support networks.
  • Patterns of acculturation:
    • Integration (low stress)
    • Assimilation (moderate)
    • Separation (high)
    • Marginalization (greatest).

Physical Effects of Stress — The Mind–Body Connection

  • Stress affects health indirectly (sleep, eating, substance use) & directly (physiological changes).

Fight-or-Flight (Walter Cannon)

  • Immediate sympathetic–adrenal-medullary (SAM) activation → catecholamines (adrenaline, noradrenaline) → ↑ heart rate, blood pressure, respiration, blood to muscles, pupil dilation, ↓ digestion.

Endocrine Pathways

  1. Acute stress (SAM):
    \text{Hypothalamus} \rightarrow \text{Sympathetic NS} \rightarrow \text{Adrenal Medulla} \rightarrow \text{Catecholamines}
  2. Prolonged stress (HPA axis): \text{Hypothalamus} \rightarrow \text{Pituitary} releases ACTH \rightarrow \text{Adrenal Cortex} \rightarrow \text{Corticosteroids}
    • Functions: mobilize energy, reduce inflammation, dampen immunity.

General Adaptation Syndrome (Hans Selye)

  1. Alarm: catecholamine surge, heightened arousal.
  2. Resistance: attempt to adapt; arousal above baseline.
  3. Exhaustion: depletion → illness/death; alarm symptoms re-emerge irreversibly.

Telomeres & Aging

  • Telomeres: protective DNA caps; shorten with every cell division.
  • Chronic stress & high cortisol/catecholamines → shorter telomeres, accelerated aging, disease, mortality.

Immune System & Psychoneuroimmunology (PNI)

  • Lymphocytes (B & T cells) defend against pathogens.
  • CNS & immune system communicate via neurotransmitters & hormones; lymphocytes have receptors and also secrete these chemicals.
  • Stress (relationship breakup, caregiving, exams) → suppressed immunity.
  • Cohen cold studies: Higher stress → higher infection rates; chronic stressors most risky.
  • Short-term stress can sometimes enhance immunity—context matters.

Placebo Effect & Pain

  • Placebos & opioid drugs both activate anterior cingulate cortex rich in opioid receptors.
  • Expectations & emotions can modulate pain perception via endogenous opioids.

Psychological Factors Modifying Stress Response

Personal Control

  • Realistic sense of control reduces distress & arousal.
  • Valued more in individualistic cultures.
  • Nursing-home residents with choice (plants, schedules) → healthier & happier.

Explanatory Style (Seligman)

  • Optimistic: external, unstable, specific attributions for failure → stronger immunity & health.
  • Pessimistic: internal, stable, global attributions → poorer outcomes.

Chronic Emotions

  • Habitual anxiety, depression, anger, hostility → higher risk of arthritis, heart disease.
  • Positive emotions linked to lower illness, pain, & longer life.

Type A vs. Type B

  • Type A: time urgency + hostility → greater BP & HR reactivity, heart disease.
  • Type B: relaxed, easygoing, lower risk.
  • Caution: correlations; disease might affect mood; poor habits mediate link.

Social Support

  • Definition: resources supplied by others (emotional, informational, tangible).
  • Low support: doubles mortality risk; predicts loneliness, cognitive decline.
  • Diverse networks: fewer colds, strokes, dementia.
  • Benefits: buffers appraisal, dampens physiological reactivity, offers direct aid.
  • Negatives: conflict, unwanted advice, stress contagion (more common in women).
  • Gender:
    • Men lean on spouse; isolation risky.
    • Women broader confidants but also caregiving burden.

Helpful vs. Unhelpful Responses

  • Helpful: active listening, empathy, questions, time investment.
  • Unhelpful: unsolicited advice, “I know exactly…”, self-focus, minimization, forced cheer, preachy interpretations.

Coping Strategies

Adaptive vs. Maladaptive

  • Adaptive: realistic appraisal, problem solving, emotion regulation.
  • Maladaptive: rumination, avoidance, substances, self-defeat.

Problem-Focused Coping

  • Managing/changing the stressor; best when control is possible.
    • Planful problem solving: rational analysis → solution implementation.
    • Confrontational coping: assertive risk taking; effective if non-hostile.

Emotion-Focused Coping

  • Used when stressor seems uncontrollable; regulates feelings. Strategies:
    • Escape–avoidance (distraction, fantasy).
    • Seeking social support.
    • Distancing (cognitive detachment).
    • Denial.
    • Positive reappraisal (finding meaning).
    • Religious coping:
    • Positive: faith, forgiveness, community.
    • Negative: anger at deity, spiritual doubt → worse outcomes.

Culture & Coping

  • Individualistic cultures: value autonomy, control, favor problem-focused (confrontive, planful), less likely to seek help.
  • Collectivistic cultures: emphasize group harmony, favor emotional regulation, support-seeking, adjusting personal reactions.

Minimizing the Effects of Stress — Practical Tips

  1. Limit stimulants (caffeine, nicotine, amphetamines).
  2. Exercise regularly (aerobic & strength).
  3. Sleep sufficiently (≈ 7!–!9 hrs adults).
  4. Relaxation/Meditation: mindfulness of breathing, progressive muscle relaxation.