Health Psychology & Stress

Health Psychology

  • Health Psychology: The study of the psychological & behavioral factors that influence the prevention and treatment of illness & the maintenance of health.
  • Related to behavioral medicine.

Health-Enhancing Behaviors

  • Regular health screening
  • Adequate rest, nutrition, & exercise.

Health-Compromising Behaviors

  • High-risk behaviors such as substance abuse and unprotected sex
  • Unhealthy lifestyle
  • Stress
  • Lack of rest, poor coping mechanisms, inadequate nutrition, lack of exercise

Stress

  • Transactional model of stress (Lazarus): A pattern of cognitive appraisals, physiological responses & behavioral tendencies that occur in response to a perceived imbalance between situational demands & the person’s ability to cope with them.
  • Stressors: Potentially threatening events
    • Life events
    • Daily hassles
    • Controllable vs uncontrollable stress

Types of Stress

  1. Frustration: Some goal is thwarted.
  2. Change: Noticeable change in one’s living situation that requires adjustment.
  3. Pressure: Expectations/demands to react in a certain way.
  4. Conflict: Two or more incompatible motives or behavioral impulses compete for expression.

Holmes & Rahe Stress Scale

  • Life Event Check: Used to assess stress levels by assigning numerical values to various life events.
  • Instructions:
    • Check each life event that was experienced over the past year (adding values if any event occurred more than once).
    • Total the scores (total score predicts risk of developing illness in the near future).
  • Score Interpretation:
    • 300+: You have a high or very high risk of becoming ill in the near future.
    • 150-299: You have a moderate to high chance of becoming ill in the near future.
    • <150: You have only a low to moderate chance of becoming ill in the near future.
  • Examples of Life Events and Scores:
    • Death of a spouse: +100
    • Divorce: +73
    • Marital Separation: +65
    • Jail term: +63
    • Death of close family member: +63
    • Personal illness or injury: +53
    • Marriage: +50
    • Fired at work: +47
    • Marital Reconciliation: +45
    • Retirement: +45
    • Change in health of Family member: +44
    • Pregnancy: +40
    • Sexual difficulties: +39
    • Gain new family member: +39
    • Business readjustment: +39
    • Change in financial state: +38
    • Death of close friend: +37
    • Change to different line of work: +36
    • Change in number of arguments with spouse: +35
    • Taking on mortgage or large loan: +31
    • Foreclosure of mortgage or loan: +30
    • Son or daughter leaves home: +29
    • Trouble with in-laws: +29
    • Outstanding personal achievement: +28
    • Begin or end school /college/university: +26
    • Change in residence: +20
    • Change in sleep habits: +16
    • Vacation: +13

Stress & Motivation

  • An “optimal” level of stress is required to function adequately. The fight or flight response can be adaptive.
  • Very low levels of stress are associated with depression and lack of motivation.

Selye's General Adaptation Syndrome

  • Model refers to the physical side of stress.
  • Limitation: ignores cognitive appraisals of stress.
  • Stages:
    • Alarm: During the first stage, the body mobilizes its resources.
    • Resistance: In the second stage, resistance levels off and eventually begins to decline.
    • Exhaustion: In the third stage, resistance is depleted, leading to exhaustion.

The Role of Cognitive Appraisals

  1. Primary Appraisal: Perceive a situation as threatening.
  2. Secondary Appraisal: Believe that you will be unable to cope.
    • Hingson et al., 1990.

Stress and Health

  • Stress plays a role in 50 - 70% of all physical illnesses.
    • Examples: heart disease, ulcers, diabetes, migraines
  • High stress levels:
    • Interfere with immune system functioning.
    • Are correlated with the common cold.
  • Statistics Canada (2004) study:
    • Adults who reported high stress in 1994-95 had an increased risk of developing chronic health conditions by 2000-2001 (including arthritis, rheumatism, bronchitis, emphysema, & ulcers).
    • Males also faced increased risk of heart disease, and females, asthma and migraines.
    • More stressors = greater risk
    • Females – 3 ongoing stressors, 24% > risk of developing chronic health condition.
    • Males – 3 ongoing stressors, 18% > risk

Personality & Stress

  • Optimism is positively correlated with:
    • Higher Self-esteem
    • Greater hardiness (control, commitment, & challenge)
    • Internal locus of control
    • Greater hopefulness
    • Lower anxiety
  • Pessimism is correlated with:
    • Low self-esteem
    • Less hardiness
    • External locus of control
    • More hopelessness
    • Higher anxiety

Optimists and Pessimists: Contrasting Strategies for Coping with Stress

  • Optimists:
    • Make specific plans for dealing with stress; implement these plans.
    • Obtain advice from others.
    • Engage in emotion-releasing activities instead of working on the problem directly.
  • Pessimists:
    • Refrain from other activities until stress is reduced.
    • Ignore the problem or source of stress.
    • Give up on reaching goals blocked by stress.

Therapies

  • Minimizing Risk Factors for Stress & Illness
    • Lifestyle changes
      • Diet
      • Exercise
      • Control substance use
      • Smoking cessation
      • Monitor blood pressure
    • Stress management

Stress Management

  • Use of behavioral strategies to reduce stress & improve coping skills.
  • Techniques:
    • Progressive Relaxation: Produces deep relaxation throughout the body.
    • Guided Imagery: Visualizing images that are calming, relaxing or beneficial.
    • Stress Inoculation: Using positive coping statements to control fear and anxiety.
    • Coping Statements: Reassuring, self-enhancing statements.

Stress & Mental Health

  • VULNERABILITY-STRESS MODEL: For explaining many psychological disorders.
  • SEVERE REACTIONS TO STRESS
    • Acute Stress Reaction
    • PTSD
    • Dissociative disorders
  • Stress & Physical Health
  • VULNERABILITY FACTORS include:
    • Lack of support network
    • Tendency to become anxious or pessimistic.
    • Poor coping skills
    • Make individuals more vulnerable to negative health consequences.

Stress & Health: Protective Factors

  • COGNITIVE FACTORS
    • Optimistic attitude:
      • Better immune system functioning
      • More health-enhancing behaviors
    • Self-efficacy: Belief that one can cope
    • Finding meaning in stressful events
  • SOCIAL SUPPORT
    • Better immune system functioning
    • Better health

Coping

  • CONSTRUCTIVE COPING = healthy ways of coping with stress.
    1. Problem-Focused coping: Confront problem directly.
    2. “Reasonably realistic” appraisals of stress & ability to cope.
    3. Emotion-Focused coping: Recognize/control destructive emotion
    4. Efforts to avoid vulnerability to stress. Wise & timely decisions

Suicide

  • Devastating effects on survivors.
    • Some develop PTSD
  • More women than men attempt suicide.
  • More men than women die by suicide (more lethal methods).
  • Approximately 3500 annually in Canada.

Myths about Suicide

  • People attempt suicide just to get attention. (False)
  • If you talk to someone about their suicidal feelings, they’re more likely to attempt suicide. (False)
  • All those who commit suicide are depressed. (False)
  • If someone wants to commit suicide, there is no way to stop them. (False)

Suicide Risk Factors

  1. BIOLOGICAL FACTORS
    • Suicide is not hereditary; however, there is a biological predisposition for certain illnesses.
  2. PSYCHOLOGICAL FACTORS
    1. Presence of a psychological disorder (e.g., Depression, Schizophrenia, substance abuse)
    2. Cognitive Factors
      • Negative attitudes
      • Hopelessness
      • Restricted thinking
      • Rumination
    3. Emotional Factors
      • High levels of negative emotion
      • Difficulty regulating emotion
    4. Learning Theory
      • “Contagion effects”
  3. ENVIRONMENTAL FACTORS
    • Lack of social support
    • Stress Reactions
    • Major loss

Preventing Suicide

  • WARNING SIGNS
    • Suicide threats
    • “Leave taking” behavior (e.g., will, giving away possessions)
    • Sudden improvement in mood
  • PREVENTING SUICIDE
    • Commitment to mental health.
    • Seeking support (or professional help).
    • “Keeping the fatal secret?”

Treating Alcohol Abuse

  • Aversion Therapy
  • Relapse Prevention
  • Multimodal Treatment
    • Relaxation, stress management, coping & social skills, marital & family counseling, positive reinforcement
  • Motivational Interviewing
    • To increase awareness of problem, self-efficacy, & desire to take action.

Stages of Change Model

  • Precontemplation
  • Contemplation
  • Preparation
  • Action
  • Maintenance
  • Termination

Positive Psychology

  • Focuses on happiness, well-being, and life satisfaction, personal strengths, wisdom, creativity, imagination, and characteristics of positive groups and positive institutions.
  • Scientific study of health & well-being
  • Hedonic well-being
  • Eudaimonic well-being

How to Be Happy

  • Spend time with other people & work to develop close relationships.
  • Look for ways to be helpful to others, & reach out to the less fortunate.
  • Seek meaning and challenge in work.
  • Set meaningful personal goals and make progress towards them.
  • Make time for enjoyable activities.
  • Nurture physical well being.
  • Be open to new experiences.
  • Cultivate optimism and count your blessings.

Leading Causes of Death in Canada, 1994

  • Cancer
  • Heart disease
  • Cerebrovascular diseases (e.g. stroke)
  • Chronic lung disease
  • Accidents
  • Pneumonia and influenza
  • Diabetes
  • Suicide
  • Kidney disease
  • Liver disease
  • HIV infection
  • All other causes