Stress, Lifestyle, and Health

WHAT IS STRESS?

  • Definition: Stress refers to the process by which we appraise and respond to events that challenge or threaten us (stressors).
  • Stressor Types:
    • Chronic stressors: Persist over an extended period.
    • Acute stressors: Brief, focal events that can be overwhelming.
  • **Appraisal Process (Figure 14.3):
    • Primary Appraisal:
      • Determining if an event is a challenge or threat.
      • Challenge: Potential for gain or growth.
      • Threat: May lead to harm, loss, or negative consequences.
    • Secondary Appraisal:
      • Evaluating potential options and their effectiveness in coping with the stressor.
      • Effective options: Low threat.
      • Ineffective or no options: High threat.
  • Stress Responses: Varying reactions to stress, which can be physiological, cognitive, and behavioral.
    • Physiological: Accelerated heart rate, headaches, gastrointestinal problems.
    • Cognitive: Difficulty concentrating or making decisions.
    • Behavioral: Drinking alcohol, smoking, or taking actions to eliminate the cause of stress.
  • Types of stress:
    • Acute
    • Chronic
    • Ambient
  • Sources of stress:
    • Frustration
    • Internal conflict
    • Change / Pressure

HARMFUL VS. EUSTRESS

  • Eustress:
    • Good stress associated with positive feelings, optimal health, and performance (Greek eu = “good”).
    • Can motivate desirable behaviors like studying for exams or exercise.
    • Moderate stress can be beneficial in challenging situations.
  • **Performance and Stress (Figure 14.4):
    • As stress increases from low to moderate, performance also increases (eustress).
    • Optimal level (peak of curve): Performance has peaked.
    • Stress exceeds optimal level: Reach distress region which is excessive and debilitating stress, and performance declines.
    • People who reach distress feel burned out, fatigued, exhausted, and performance declines.
  • Nearly half of U.S. adults indicated that their stress levels have increased over last five years (Figure 14.5).

PHYSIOLOGICAL RESPONSES TO STRESS

  • Physiological responses (e.g., accelerated heart rate, headaches, or gastrointestinal problems)
  • Cognitive responses (e.g., difficulty concentrating or making decisions)
  • Behavioral responses (e.g., drinking alcohol, smoking, or taking actions directed at eliminating cause of stress)
  • Health psychology: Scientific study of how stress and other psychological factors impact health and how people respond to illness.

STRESS AMONG DEMOGRAPHIC GROUPS

  • Stress levels vary among different demographic groups (Figure on page 9), including age, sex, education, employment, race, and income.

FIGHT-OR-FLIGHT RESPONSE

  • Walter Cannon articulated fight-or-flight response, sympathetic nervous system response to a significant stressor.
  • Homeostasis:
    • Assists in maintaining homeostasis - physiological variables like blood pressure, respiration, digestion, and temperature are at optimal level for survival
    • Helps us adjust internally and externally to changes in surroundings
  • Physiological Response:
    • Pupils dilate
    • Heart rate increases
    • Muscles tense and may tremble
    • Respiration quickens; bronchial tubes dilate
    • Perspiration begins

GENERAL ADAPTATION SYNDROME

  • Hans Selye:
    • World’s foremost stress expert, incidentally discovered that prolonged negative stimulation (stressors) caused rats to show signs of adrenal enlargement, thymus and lymph node shrinkage, and stomach ulceration.
    • Regardless of stressor type, same reaction pattern.
  • General adaptation syndrome: Body’s nonspecific physiological response to stress. Includes:
    • (1) Alarm reaction: Body’s immediate reaction (fight or flight).
    • (2) Stage of resistance: Body has adapted to stressor, remains on alert, and prepared to respond like alarm reaction with less intensity.
    • (3) Stage of exhaustion: No longer able to adapt and resist; physical wear on body’s tissues and organs. Illness, disease, and other permanent body damage may occur.
  • Stages of General Adaptation Syndrome Figure 14.9

PHYSIOLOGICAL MECHANISMS OF STRESS

  • Stress physiological mechanisms involve two systems:
    • Autonomic nervous system: sympathetic and parasympathetic
    • Hypothalamic-pituitary-adrenal (HPA) axis

HYPOTHALAMIC-PITUITARY-ADRENAL (HPA) AXIS

  • Alarm reaction: Sympathetic triggers arousal via release of adrenaline
    • Activates fight-or-flight response (alarm)
    • Simultaneously HPA axis activates (slower)
    • Hypothalamus tells pituitary gland to release ACTH
    • ACTH activates adrenal glands to secrete cortisol
  • Harmful Effects of Extended Cortisol Release:
    *Psychological: Post-traumatic stress disorder, major depressive disorder, and other conditions.
    *Significantly weakens immune system and high blood pressure.

STRESSORS

  • Traumatic Events:
    • When person is exposed to actual or threatened death or serious injury
    • Men, non-Whites, and lower SES groups report more traumatic events than do women, Whites, and higher SES groups
  • Post-traumatic stress disorder (PTSD):
    • A chronic stress reaction characterized by experiences and behaviors that may include intrusive and painful memories of the stressor event, jumpiness, persistent negative emotional states, detachment from others, angry outbursts, and avoidance of reminders of event

SOCIAL READJUSTMENT RATING SCALE (SRRS)

  • 43 life events that require readjustment
  • Many pleasant life events are listed!
  • Life events can add up over time
  • Experiencing a cluster of stressful events increases risk of illnesses
  • SRRS criticism: does not account for respondents’ appraisals of life events

DAILY HASSLES

  • Minor irritations and annoyances that are part of daily life
  • Can build and leave us just as stressed as life-changing events

STRESSFUL JOBS

  • Stressful jobs have heavy workload and uncertainty about and lack of control over certain aspects of job.
  • Job strain:
    • A work situation that combines excessive job demands and workload with little discretion in decision making or job control
    • Many occupations involve moderate amount of job strain.
  • Job burnout:
    • A general sense of emotional exhaustion and cynicism in relation to one’s job.
    • Occurs frequently among people in human service jobs (e.g., social workers, teachers, police officers).
  • Other Stressors:
    • Lack of supervisory support

RELATIONSHIP STRESS

  • Close relationships with friends and family are source of stress
  • Negative aspects include adverse exchanges, conflicts, lack of emotional support, and lack of reciprocity
  • Can take emotional and physical toll

STRESS AND ILLNESS

  • If stress is chronic or frequently exceeds normal ranges, lead to cumulative wear and tear on body
  • High levels of cortisol become vulnerable to infection or disease → lower immune functioning
  • Physical disorders or diseases that are worsened by stress and emotional factors - psychophysiological disorders
    • Physical symptoms exacerbated by psychological factors

PSYCHOPHYSIOLOGICAL DISORDERS (EXAMPLES)

  • Cardiovascular: hypertension, coronary heart disease
  • Gastrointestinal: irritable bowel syndrome
  • Respiratory: asthma, allergy
  • Musculoskeletal: low back pain, tension headaches
  • Skin: acne, eczema, psoriasis

NEUROTICISM AND IMMUNITY

  • Neuroticism: Identified as a risk factor for chronic health problems and mortality
  • Immune system: Major pathways that stress and emotional factors can take leading to illness and disease
    • Body’s surveillance system
    • Variety of structures
    • Protects body from invading toxins and microorganisms
    • Eliminating bacteria, viruses, and other foreign substances

PSYCHONEUROIMMUNOLOGY

  • Psychological factors influence immune system and functioning (1981)
  • Studied many brief and chronic stressors and their effect immune system
  • Many stressors associated with poor or weakened immune functioning
  • Stress hormones released during HPA axis activation adversely impacts immune function
    • Inhibiting production of lymphocytes, white blood cells that are important in immune response

CHRONIC STRESSORS AND COLDS

  • % of participants that developed colds (after receiving cold virus) after experiencing chronic stressors lasting at least 1, 3, and 6 months (FIGURE 14.15)

TELOMERES AND STRESS

  • Telomeres shorter in people with more childhood trauma
  • Telomeres protect ends of chromosomes
  • Shortened telomeres inhibit or block cell division → leading to more rapid aging

CARDIOVASCULAR DISORDERS

  • Cardiovascular disorders are focus of psychophysiological disorders because central to stress response
  • Heart disease one in three US deaths and leading cause of developed world deaths
  • Risk factor = hypertension or high blood pressure
    • Work harder = more strain
    • Can lead to heart attack, stroke, heart failure, kidney failure, and blindness
    • “Silent killer” because asymptomatic
    • Risk factors: social (aging, income, education, and employment status), behavioral (unhealthy diet, tobacco use, physical inactivity, and excessive alcohol consumption), obesity and diabetes
  • Symptoms of heart disease - angina—chest pains or discomfort when heart does not receive enough blood, burning sensations in chest, and shortness of breath
    • Can spread to arms, neck, jaws, stomach (as nausea), and back

TYPE A PERSONALITY

  • Type A - aggressive and chronic struggle to achieve more, excessive competitive drive, chronic sense of time urgency, impatience, and hostility toward others
  • Type B - more relaxed and laid-back
  • Heart disease more frequent among Type As
  • Anger/hostility dimension related to development of heart disease
  • Suppressed hostility substantially elevated heart disease risk for men and women

TRANSACTIONAL MODEL OF HOSTILITY

  • Thoughts and feelings of hostile person promote antagonistic behavior toward others
  • Which reinforces complimentary reactions from others
  • Intensifying ones’ hostile disposition
  • Angry and hostile moods might create social strain that lays foundation for disease-promoting cardiovascular responses among hostile individuals

NEGATIVE AFFECTIVITY AND HEART DISEASE

  • Heart disease linked to:
    • Negative affectivity – tend to experience distressed emotional states involving anger, contempt, disgust, guilt, fear, and nervousness
    • Vital risk factor for development of cardiovascular disorders
    • Type D personality
    • Depression
  • Heart attacks (men and women) by depression score, Heart disease have more depression, Depressed people more likely to develop heart disease and higher mortality

REGULATION OF STRESS

  • Coping - mental and behavioral efforts to deal with stress

COPING MECHANISMS

  • Problem-focused coping:
    • Manage or alter problem causing stress
    • Similar to strategies as everyday problem-solving
  • Emotion-focused coping:
    • Efforts to change or reduce negative emotions from stress
    • Avoiding, minimizing, or distancing from problem
    • Positive comparisons with others
    • Seeing something positive in a negative event
  • Reappraisal:
    • Stressor is construed differently without changing level of threat
  • When to use which:
    • Problem-focused more likely = controllable stressor
    • Emotion-focused more likely = uncontrollable stressor

PERCEIVED CONTROL

  • Stress reactions depend on perceived control - beliefs about personal capacity to exert influence over and shape outcomes
  • Personal control = better physical and mental health and greater psychological well-being ; lower reactivity to daily stressors
  • Lack of personal control over threatening, harmful, or noxious events = negative psychological consequences

LEARNED HELPLESSNESS

  • Seligman experiments
    • Dogs were placed in chamber and received inescapable electric shocks
    • When dogs could escape shocks most failed to try
    • Gave up and passively accept
    • Dogs that could previously escape shocks tended to escape shocks
  • Learned helplessness - belief that they were powerless to do anything about noxious stimulation

HOPELESSNESS THEORY

  • Reformulated Seligman study holds that negative life events contribute to depression
  • Model suggests three kinds of attributions for outcome
    • internal vs. external
    • stable vs. unstable
    • global vs. specific
  • Hopelessness theory explains onset of major depressive disorder

SOCIAL SUPPORT

  • Strong interpersonal relationships with close, caring individuals that help during times of distress, sorrow, and fear
  • Includes: advice, guidance, encouragement, acceptance, emotional comfort, and tangible assistance (such as financial help)
  • Psychosocial factors affecting health outcomes
  • Magnitude of social support effect = quitting smoking
  • Low levels of social support → greater risk of mortality
  • Higher levels of social support → better survival rates following breast cancer and infectious diseases, HIV, and decreased common cold
  • Social support boosts immune system, reduces blood pressure during stressful tasks

EXERCISE AND RELAXATION

  • Exercise reduces effects of stress on telomeres, hippocampus and memory
  • Reduces anxiety and depressive symptoms
  • Relaxation response technique - combines relaxation with transcendental meditation, and four components:
    • Sit on comfortable chair relaxed position
    • Quiet environment with eyes closed
    • Repeat word or phrase - mantra - to oneself
    • Passively allow mind to focus on pleasant thoughts
  • Reduces sympathetic arousal
  • Biofeedback - uses electronic equipment to accurately measure a person’s neuromuscular and autonomic activity
    • Gain voluntary control over involuntary
    • Used successfully with tension headaches, high blood pressure, asthma, and phobias

THE PURSUIT OF HAPPINESS

  • Happiness - an enduring state of mind consisting of joy, contentment, and other positive emotions, plus sense that one’s life has meaning and value
    • Implies that happiness is a long-term state
    • Often characterized as subjective well-being – not a transient mood

DISTINCT ELEMENTS OF HAPPINESS

  • The pleasant life - attainment of day-to-day pleasures that add fun, joy, and excitement to life
  • The good life - identifying unique skills and abilities and engaging these talents to enrich our lives
  • The meaningful life - deep sense of fulfillment that comes from using talents in service of greater good

FACTORS CONNECTED TO HAPPINESS

  • Age Life satisfaction usually increases with age.
  • Family and social relationships
    • Married people report being happier than those that are not.
    • High-quality social relationships and strong social support networks correlate with increased happiness.
  • Money
    • A nation’s gross domestic product (GDP) is associated with happiness levels.
    • Wealthy individuals tend to be happier than poor individuals.
    • Happiness increases with income only up to 75,00075,000.
  • Religion
    • In nations with difficult living conditions, religiosity is associated with greater well-being but does not make a difference in nations with favorable living conditions.
  • Culture People that possess characteristics values in their culture tend to be happier.

AFFECTIVE FORECASTING

  • People are poor at affective forecasting: predicting intensity and duration of future emotions
  • Often incorrect when estimating long-term happiness after life events
  • When people experience emotional reactions to life events, eventually adapt to changing emotional circumstances
  • When an event provokes positive or negative emotions, first we tend to experience its emotional impact at full intensity, then it becomes status quo

LONG-TERM EFFECTS ON HAPPINESS

  • Extent that important life events can permanently alter people’s happiness set points?
  • In some circumstances, happiness levels do not revert to original positions
  • Widows and those who had been laid off experienced decreases in happiness that result in long-term changes in life satisfaction

SIGNIFICANT LIFE EVENTS

  • Life satisfaction scores several years before and after three significant life events (0 represents the year the event happened)
  • Real changes in happiness are possible well-being interventions may increase happiness permanently writing down three good things that occurred each day led to increases in happiness

POSITIVE PSYCHOLOGY

  • Science of happiness; seeks to identify and promote qualities that lead to greater fulfillment; focus on people’s strengths and what helps individuals to lead happy and content lives

POSITIVE AFFECT AND OPTIMISM

  • Positive affect:
    • Pleasurable engagement with environment, such as happiness or joy
    • Can be brief, long-lasting, or trait-like
    • Associated with greater social connectedness, emotional and practical support, adaptive coping efforts, lower depression, longevity, and favorable physiological functioning
  • Optimism:
    • Tendency to look on bright side of things “Don’t worry, be happy”
    • View life’s stressors and difficulties as temporary and external
    • Linked to longevity, healthier behaviors, fewer postsurgical complications, better immune functioning, and better treatment adherence
    • Report fewer physical symptoms, less pain, better physical functioning, and less likely to be re-hospitalized following surgery
    • Positive affect concerned with positive feeling states
    • Optimism generalized tendency to expect that good things will happen

FLOW

  • Particular experience that is so engaging and engrossing it becomes worth doing for its own sake
  • Fosters a deep sense of well-being
  • Usually related to creative and leisure activities, can be experienced by workers or students
    • Pleasurable experience
    • Occurs when people are engaged in challenging activities that require skills and knowledge they know they possess
    • An activity that you are truly enthusiastic about, something so absorbing that doing it is the reward