Health, Stress & Coping – Comprehensive Study Notes

HEALTH PSYCHOLOGY: SCOPE & CORE IDEAS

• Discipline focus: understanding psychological influences on staying healthy, falling ill, reacting to illness (Taylor, 2003).

• Biopsychosocial model- Illness

= biology alone → interaction of biological, psychological, social variables.
- Underpins all contemporary health–behaviour theories & interventions.

• Community Health Psychology- Targets social determinants (e.g., socioeconomic status, racism, COVID-19 inequities).

  • Aims: health promotion in marginalised groups, structural change, community-led programs (e.g., Healthy Families NZ).

• Real-world illustration- Christchurch Al-Noor mosque massacre (2019) & Devonport jumping-castle tragedy (2021) used to frame questions on prolonged stress, coping, media exposure.

WELLBEING: MULTIDIMENSIONAL PERSPECTIVE

• Definition: state of being comfortable, healthy, happy; involves quality relationships, life satisfaction, happiness.

• Interacting domains: environmental, social, biological, lifestyle, spiritual, vocational, societal, socioeconomic.

• Key Australian trends (APS Wellbeing Surveys)- ↓ Wellbeing since 2011; ↑ anxiety (26 %), depression (26 %), stress (35 %).

  • Top stressor = finances; coping behaviours often maladaptive (61 % drink alcohol, 40 % smoke, 31 % use drugs).

• Digital era issues: Fear of Missing Out (FOMO)- Adults: 32 % care about decoding friends’ in-jokes; Teens: 78 %.

  • Heavy social-media use (>5× day) → sleep difficulty (57 %), burnout (60 %).

• Indigenous SEWB snapshot (AIHW 2020b)- Anxiety 24 %; psychological distress 2.3× non-Indigenous.

  • Shift to Indigenous-led wellbeing initiatives (e.g., NACCHO; apps like iBobbly, My Mob).

• Emerging research: Gut–microbiome–brain axis; gamification & wellbeing apps; mindfulness (Kabat-Zinn: “paying attention … non-judgementally”).

THEORIES OF HEALTH BEHAVIOUR

• Health Belief Model (HBM)- Core cognitions: perceived susceptibility, severity, benefits vs barriers, cues-to-action.

  • Optimistic bias reduces perceived susceptibility.

• Protection Motivation Theory = HBM + self-efficacy.

• Theory of Reasoned Action (TRA)- Behaviour ← intention ← (attitude toward behaviour, subjective norms).

• Theory of Planned Behaviour (TPB) = TRA + perceived behavioural control (self-efficacy).

• Transtheoretical/Staged-Change Model (TTM)

1. Pre-contemplation

   2. Contemplation

   3. Preparation

   4. Action (≈6 mths)

   5. Maintenance
      • Relapse possible; recycling common.

   • NZ research: movement along stages ↑ fruit/veg intake (Māori women; Jury & Flett 2010).

HEALTH-COMPROMISING BEHAVIOURS

1. Obesity

• Prevalence AU 2017-18: 36 % overweight + 31 % obese (= 67 %). Child (2–17 y): 25 %.

• Formula: BMI = weight (kg) / height (m)^2

• Cut-offs: Overweight 25–30; Obese >30; Waist risk >94 cm (m) / >80 cm (f).

• Contributors: genetics (≈40 % heritable; leptin pathway; susceptible-gene hypothesis), high-fat diets, sedentary jobs, portion sizes, screen time (~26 h/week kids), socioeconomic factors.

• Consequences: CVD, Type 2 diabetes, cancers, musculoskeletal strain, cognitive decline, stigma/discrimination (e.g., employment, income). Economic cost AU ≈ 56.6 billion ➔ projected 87.7 billion by 2025.

• Treatments: diet/exercise (≤ 15 % long-term maintainers), pharmacotherapy (e.g., appetite suppressants), bariatric surgery (gastroplasty, gastric bypass), multi-stage stepped-care models (Wadden et al.).

2. Cigarette Smoking

• Global smokers 2017: >1 billion; AU daily rates declining (school-aged down; APS data).

• Indigenous AU 2019: 43.4 % vs <14 % non-Indigenous.

• Health toll: 21 000 AU deaths/yr; approximately 13–14.5 life-years lost.

• Contributors: genetics (44 % initiation; 75 % dependence), nicotine metabolism speed, peer modelling, self-presentation (“looking tough/rebellious”), dopamine reward.

• Interventions: taxation, advertising bans, plain packaging, Quitline 137 848, HBM-style campaigns, pharmacotherapy (NRT gum/patch/spray; varenicline, bupropion), CBT, hypnosis, social support (+50 % quit success).

3. Alcohol Abuse

• AU per-capita consumption ~9.3 L pure alcohol/yr (OECD 2021).

• Risky/high-risk ≥ monthly: 25 % total; 18–24 y = 41 %.

• Genetic load ~30–50 % heritable; dopamine gene variants, tolerance to aversive effects.

• Psychosocial motives: self-handicapping, stress escape, peer norms.

• Consequences: liver disease (40 % cancer burden in liver), CVD, accidents, violence, suicide, 15.3 B+ social cost/yr.

• Treatment spectrum: spontaneous remission (≈19 %), detoxification & inpatient rehab, aversion therapy (Antabuse), acamprosate, naltrexone, emerging pindolol trials, CBT (stress-management), 12-step (AA).

4. Sexually Transmitted Diseases (STDs)

• >20 recognised; Chlamydia most common AU 2019 (103 000 notifications; 423.2/100 000).

• Trends ↑ chlamydia, gonorrhoea, syphilis; concerns for vertical transmission.

• Prevention hindered by self-presentation embarrassment purchasing/negotiating condom use.

• Innovative responses: WA “condom trees” (PVC-pipe dispensers) to reduce purchase-related embarrassment.

BARRIERS TO HEALTH PROMOTION & PREVENTION

• Individual: immediate rewards (taste, relaxation), delayed costs, optimistic bias, defensive avoidance (“what I don’t know…”), gender gap (men ↓ preventive behaviours).

• Family: modelling of parents/siblings; health habits transmitted inter-generationally.

• Health-system: biomedical focus on illness not prevention; access inequities (insurance); doctor–patient communication gaps, language/culture mismatch; time pressure & malpractice climate; compliance issues.

• Community/Cultural: local norms (smoke-free workplaces ↓ rates), large-scale campaigns (‘Life. Be in it.’), Indigenous health disparities (10-yr life-expectancy gap), structural poverty.

• Self-presentation as cross-cutting barrier → influences tanning, substance use, condom non-use, avoidance of exercise due to body image.

STRESS: CONCEPTS & MODELS

• Definition: challenge to adaptation capacities.

• Psychobiology- Cannon (1932) fight-or-flight.

  • Selye’s General Adaptation Syndrome (GAS)

1. Alarm – SNS + HPA activation (adrenaline, cortisol).

2. Resistance – sustained arousal; immune shift.

3. Exhaustion – resource depletion; illness vulnerability.

• Transactional Model (Lazarus & Folkman)- Primary appraisal (harm/loss, threat, challenge) + Emotional forecasting.

  • Secondary appraisal (coping options, perceived control).

• Types of Stressors- Life events (Holmes-Rahe scale; e.g., death of spouse = 100 LCU).

  • Major stressors: bereavement (elevated mortality within 6 mths), unemployment.

  • Acculturative stress (language barriers, discrimination, identity conflict).

  • Catastrophes: bushfires (Black Saturday 2009 death toll 173), floods (QLD 2011), Japanese earthquake/tsunami 2011, COVID-19 pandemic (>274 M cases; 5.3 M deaths by Dec 2021).

  • Daily hassles: weight concerns, traffic, lost keys.

STRESS ➔ HEALTH PATHWAYS

• Psychoneuroimmunology (PNI): psychosocial factors <> immune (B-cells, T-cells, NK cells).

• Stress ↓ IgA (student exams), ↓ NK activity (caregivers), ↑ infection risk (Cohen et al. viral-challenge; high stress doubled cold rates).

• Indirect routes: stress-induced behaviours (↑ smoking, ↓ sleep, ↓ exercise).

• Personality moderators- Type A (impatience, competitiveness) → hostility component linked to coronary disease.

  • Neuroticism → ↑ daily problems & reactivity.

  • Optimism → better CABG recovery; pessimistic explanatory style = ↑ illness days.

  • Genetic influences on both exposure & reactivity (30–40 % heritable for victimisation events).

COPING STRATEGIES

• Problem-Focused Coping: change stressor (planning, seeking info, direct action).

• Emotion-Focused Coping: regulate feelings (reappraisal, acceptance, distraction, substance use).

• Cultural patterns: minority “low-effort syndrome” → adaptive disengagement when systemic barriers persist.

• Social Support- Quantity & quality predict lower morbidity/mortality; similar magnitude to smoking effect.

  • Models: Buffering (protects under high stress) vs. Main-effect (continuous benefit).

  • Forms: perceived vs. received; excessive/ill-timed aid can backfire.

  • Loneliness statistics: 3/5 Australians view loneliness as growing issue; 87 % link to health.

• Disclosure & Health (Pennebaker)- Writing/talking about trauma → improved immune markers, fewer health-centre visits, reduced intrusive thoughts.

  • Mechanisms: cognitive processing, emotional catharsis, decreased inhibition burden.

• Post-Traumatic Growth (PTG): transformative positive change in life philosophy, meaning-making post trauma.

FUTURE DIRECTIONS IN HEALTH PSYCHOLOGY

• Ageing populations → chronic

-illness management, caregiver stress.

• Environmental & societal focus: influence of built environment, community norms, Westernisation effects.

• Global health goals- UN Millennium Development Goals (8) (2000-2015) → transition to Sustainable Development Goals (17) (2015-2030) (e.g., SDG 3 “Good Health & Well-being”).

• Health disparities: poverty elimination, Indigenous health gap targets (Close the Gap).

• Technology & e-Health- Telehealth (21 M AU sessions Mar 2020–Sep 2021), internet interventions, app-based wellbeing, remote CBT.

• Emerging challenges: pandemics (COVID-19), new infectious diseases, bioterror threats → need for behavioural insights (vaccine uptake, hygiene adherence, lockdown fatigue).