14.1 What Is Stress?

• Stress: a process whereby an individual perceives and responds to events that he appraises as overwhelming or threatening to his well-being.

  • This definition emphasizes the importance of how we appraise—or judge—demanding or threatening events (stressors); these appraisals influence our reactions to such events.

  • Primary appraisal: involves judgment about the degree of potential harm or threat to well-being that a stressor might entail.

    • A stressor would likely be appraised as a threat if one anticipates that it could lead to some kind of harm, loss, or other negative consequence

    • A stressor would likely be appraised as a challenge if one believes that it carries the potential for gain or personal growth.

  • Secondary appraisal: triggered by the perception of a threat; judgment of the options available to cope with a stressor, as well as perceptions of how effective such options will be

    • A threat tends to be viewed as less catastrophic if one believes something can be done about it

• If a person appraises an event as harmful and believes that the demands imposed by the event exceed the available resources to manage or adapt to it, the person will subjectively experience a state of stress.

• If a person doesn’t appraise an event as harmful or threatening, their is unlikely to experience stress.

Benefits of Stress

• Eustress: stress that motivates us to do things in our best interests; is associated with positive feelings, optimal health, and performance

• A moderate amount of stress can be beneficial in challenging situations.

• As stress increases, so do performance and general well-being, and when stress levels reach an optimal level, performance reaches its peak. When stress exceeds this optimal level, it’s no longer a positive force—it becomes excessive and debilitating, or distress

• Distress: a level of stress that makes one feel burned out, fatigued, exhausted, and their performance begins to decline.

  • If the stress remains excessive, health may begin to erode as well.

The Prevalence of Stress

• Stress is an experience that evokes a variety of responses, including those that are physiological, cognitive, and behavioral.

• The scientific study of how stress and other psychological factors impact health falls within the realm of health psychology

• Health psychology: a subfield of psychology devoted to understanding the importance of psychological influences on health, illness, and how people respond when they become ill.

Early Contributions to the Study of Stress

• Walter Cannon was the first to identify the body’s physiological reactions to stress.

  • Fight-or-flight response: when a person experiences very strong emotions—especially those associated with a perceived threat; the body is rapidly aroused by activation of both the sympathetic nervous system and the endocrine system

  • According to Cannon, the fight-or-flight response is a built-in mechanism that assists in maintaining homeostasis.

  • Cannon viewed the fight-or-flight response as adaptive because it enables us to adjust internally and externally to changes in our surroundings, which is helpful in species survival.

• Hans Selye discovered the general adaptation syndrome.

• General adaptation syndrome: the body’s nonspecific physiological response to stress; consists of three stages: alarm reaction, stage of resistance, and stage of exhaustion.

  • Alarm reaction: the body’s immediate reaction upon facing a threatening situation or emergency.

  • Stage of resistance: the initial shock of alarm reaction has worn off and the body has adapted to the stressor; the body remains on alert and is prepared to respond as it did during the alarm reaction, but with less intensity.

  • Stage of exhaustion: the person is no longer able to adapt to the stressor; the body’s ability to resist becomes depleted as physical wear takes its toll on the body’s tissues and organs; illness, disease, and other permanent damage to the body—even death—may occur.

The Physiological Basis of Stress

• The physiological mechanisms of stress are extremely complex, but they generally involve the work of two systems—the sympathetic nervous system and the hypothalamic-pituitary-adrenal (HPA) axis

  • Sympathetic nervous system: triggers arousal via the release of adrenaline from the adrenal glands; release of these hormones activates the fight-or-flight responses to stress, such as accelerated heart rate and respiration.

  • Hypothalamic-pituitary-adrenal (HPA) axis: primarily endocrine in nature; becomes especially active and works much more slowly than the sympathetic nervous system; releases corticotrophin-releasing factor, a hormone that causes the pituitary gland to release adrenocorticotropic hormone (ACTH)

• The ACTH activates the adrenal glands to secrete a number of hormones into the bloodstream (epinephrine, norepinephrine, cortisol)

  • Cortisol: a stress hormone that helps provide that boost of energy when we first encounter a stressor, preparing us to run away or fight.

    • Sustained elevated levels of cortisol weaken the immune system.

14.2 Stressors

• In general, stressors can be placed into one of two broad categories: chronic and acute.

  • Chronic stressors: events that persist over an extended period of time.

  • Acute stressors: brief focal events that sometimes continue to be experienced as overwhelming well after the event has ended

Traumatic Events

• Some stressors involve traumatic events or situations in which a person is exposed to actual or threatened death or serious injury.

• Some individuals who are exposed to stressors of extreme magnitude develop post-traumatic stress disorder (PTSD)

• 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 the event.

Life Changes

• Many potential stressors we face involve events or situations that require us to make changes in our ongoing lives and require time as we adjust to those changes.

• Thomas Holmes and Richard Rahe developed the Social Readjustment Rating Scale (SRRS), which provides researchers a simple way of assessing the amount of stress in people’s lives.

  • Holmes and Rahe proposed that life events can add up over time, and that experiencing a cluster of stressful events increases one’s risk of developing physical illnesses.

• Extensive research has demonstrated that accumulating a high number of life change units within a brief period of time (one or two years) is related to a wide range of physical illnesses and mental health problems.

• Regarding mental health undesirable or negative events are more strongly associated with poor outcomes than are desirable, positive events.

Hassles

• Potential stressors do not always involve major life events.

• Daily hassles: minor irritations and annoyances that are part of our everyday lives

  • Can build on one another and create as much stress as life changing events.

• Daily minor hassles, especially interpersonal conflicts, often lead to negative and distressed mood states

Other Stressors

• Two common denominators in stressful jobs/job strain: heavy workload and uncertainty about and lack of control over certain aspects of a job.

• Job strain: a work situation that combines excessive job demands and workload with little discretion in decision making or job control

• Job strain can have adverse consequences on both physical and mental health

• Job burnout: a general sense of emotional exhaustion and cynicism in relation to one’s job; consists of three dimensions - exhaustion, depersonalization, and diminished personal accomplishment.

  • Exhaustion: a sense that one’s emotional resources are drained or that one is at the end of her rope and has nothing more to give at a psychological level.

  • Depersonalization: a sense of emotional detachment between the worker and the recipients of his services, often resulting in callous, cynical, or indifferent attitudes toward these individuals.

  • Diminished personal accomplishment: the tendency to evaluate one’s work negatively by

• Job strain appears to be one of the greatest risk factors leading to job burnout,

• Depression often co-occurs with job burnout.

• Job burnout is often precipitated by feelings of having invested considerable energy, effort, and time into one’s work while receiving little in return

14.3 Stress and Illness

Psychophysiological Disorders

• Psychophysiological disorders: physical disorders or diseases whose symptoms are brought about or worsened by stress and emotional factors.

• The physical symptoms of psychophysiological disorders are real and they can be produced or exacerbated by psychological factors.

• Emotional upset and certain stressful personality traits have been proposed as potential contributors to ill health.

• Franz Alexander postulated that various diseases are caused by specific unconscious conflicts.

Stress and the Immune System

• Immune system: the body’s surveillance system; consists of a variety of structures, cells, and mechanisms that serve to protect the body from invading toxins and microorganisms that can harm or damage the body’s tissues and organs.

• Sometimes, the immune system will function erroneously.

• Immunosuppression: the decreased effectiveness of the immune system.

  • When people experience immunosuppression, they become susceptible to any number of infections, illness, and diseases.

• Psychoneuroimmunology: the field that studies how psychological factors such as stress influence the immune system and immune functioning.

• Many studies have demonstrated that immune responses can be classically conditioned in both animals and humans. Thus, if classical conditioning can alter immunity, other psychological factors should be capable of altering it as well.

• It has been repeatedly demonstrated that many kinds of stressors are associated with poor or weakened immune functioning.

• There’s a tangible physiological connection between the brain and the immune system.

• Hormones released during hypothalamic-pituitary-adrenal (HPA) axis activation can adversely impact immune function.

  • One way is by inhibiting the production of lymphocytes.

• Since stress weakens the immune system, people with high stress levels should be more likely to develop an illness compared to those under little stress.

Cardiovascular Disorders

• The cardiovascular system is composed of the heart and blood circulation system.

• The symptoms of heart disease vary somewhat depending on the type of heart disease one has, but they generally involve angina—chest pains or discomfort that occur when the heart does not receive enough blood

• A major risk factor for heart disease is hypertension

  • Hypertension: high blood pressure, which forces a person’s heart to pump harder, thus putting more physical strain on the heart.

• Risk factors contributing to cardiovascular disorders include social determinants and behavioral risk factors.

• Exposure to stressors of many kinds has also been linked to cardiovascular problems

Type A vs Type B

• Meyer Friedman and Ray Rosenman came to understand that people who are prone to heart disease tend to think, feel, and act differently than those who are not.

• Type A: tend to be intensively driven workaholics who are preoccupied with deadlines and always seem to be in a rush.

  • The major components of the Type A pattern include an aggressive and chronic struggle to achieve more and more in less and less time.

  • Specific characteristics of the Type A pattern include an excessive competitive drive, chronic sense of time urgency, impatience, and hostility toward others.

• Type B: more relaxed and laid-back

• Friedman and Rosenman were startled to discover that heart disease was over seven times more frequent among the Type As than the Type Bs

• Extensive research suggests that the anger/hostility dimension of Type A behavior pattern may be one of the most important factors in the development of heart disease.

• Negative affectivity: a tendency to experience distressed emotional states involving anger, contempt, disgust, guilt, fear, and nervousness

  • It has been linked with the development of both hypertension and heart disease.

  • It appears to be a potentially vital risk factor for the development of cardiovascular disorders.

Depression and the Heart

• Patients with heart disease have more depression than the general population, and people with depression are more likely to eventually develop heart disease and experience higher mortality than those who do not have depression

  • The more severe the depression, the greater the risk

• Depression, especially if it occurs early in life, may increase the likelihood of living an unhealthy lifestyle, thereby predisposing people to an unfavorable cardiovascular disease risk profile.

Asthma

• Asthma: a chronic disease in which the airways of the respiratory system becomes obstructed, leading to great difficulty expelling air from the lungs.

  • The airway obstruction is caused by inflammation of the airways and a tightening of the muscles around them, resulting in a narrowing of the airways.

• Asthma attacks: acute episodes in which an asthma sufferer experiences the full range of symptoms.

• Asthma exacerbation is often triggered by environmental factor.

• People with asthma tend to report and display a high level of negative emotions such as anxiety, and asthma attacks have been linked to periods of high emotionality.

• High levels of emotional distress during both laboratory tasks and daily life have been found to negatively affect airway function and can produce asthma-like symptoms in people with asthma

• The use of social media may represent a new source of stress—it may be a triggering factor for asthma attacks, especially in depressed asthmatic individuals.

• Exposure to stressful experiences, particularly those that involve parental or interpersonal conflicts, has been linked to the development of asthma throughout the lifespan.

Tension Headaches

• Headache: a continuous pain anywhere in the head and neck region.

• Migraine headaches: a type of headache thought to be caused by blood vessel swelling and increased blood flow; characterized by severe pain on one or both sides of the head, an upset stomach, and disturbed vision.

• Tension headaches: triggered by tightening/tensing of facial and neck muscles; are the most commonly experienced kind of headache

• A number of factors can contribute to tension headaches, including sleep deprivation, skipping meals, eye strain, overexertion, muscular tension caused by poor posture, and stress

• Stress may contribute to tension headaches by increasing pain sensitivity in already-sensitive pain pathways in tension headache sufferers.

14.4 Regulation of Stress

Coping Styles

• Coping: mental and behavioral efforts that we use to deal with problems relating to stress, including its presumed cause and the unpleasant feelings and emotions it produces.

• Lazarus and Folkman distinguished two fundamental kinds of coping: problem-focused coping and emotion-focused coping.

  • Problem-focused coping: one attempts to manage or alter the problem that is causing one to experience stress; involves identifying the problem, considering possible solutions, weighing the costs and benefits of these solutions, and then selecting an alternative.

  • Emotion-focused coping: consists of efforts to change or reduce the negative emotions associated with stress.

    • Can involve reappraisal, where the stressor is construed differently without changing its objective level of threat

• Problem-focused coping is more likely to occur when encountering stressors we perceive as controllable

• Emotion-focused coping is more likely to predominate when faced with stressors that we believe we are powerless to change.

• Most stressors we encounter can be modified and are, to varying degrees, controllable

Control and Stress

• Perceived control: our beliefs about our personal capacity to exert influence over and shape outcomes, and it has major implications for our health and happiness

• Perceptions of personal control are associated with a variety of favorable outcomes.

• Greater personal control is associated with lower reactivity to stressors in daily life.

• People who report higher levels of perceived control view their health as controllable, thereby making it more likely that they will better manage their health and engage in behaviors conducive to good health

• More affluent individuals experience better health mainly because they tend to believe that they can personally control and manage their reactions to life’s stressors

  • Individuals of higher social class may be prone to overestimating the degree of influence they have over particular outcomes.

• A sense of perceived control can protect less affluent individuals from poorer health, depression, and reduced life-satisfaction—all of which tend to accompany lower social standing.

Social Support

• Social support: the soothing impact of friends, family, and acquaintances; can take many forms.

• Other people can be very comforting to us when we are faced with a wide range of life stressors, and they can be extremely helpful in our efforts to manage these challenges.

• Individuals with low levels of social support are at greater risk of mortality, especially from cardiovascular disorders

• Higher levels of social supported have been linked to better survival rates following breast cancer and infectious diseases, especially HIV

• A person with high levels of social support is less likely to contract a common cold.

• If real life social support is lacking, access to distant friends via social media may help compensate.

• For some people, families are a major source of social support.

• Social support appears to work by boosting the immune system, especially among people who are experiencing stress

• Social support has been shown to reduce blood pressure for people performing stressful tasks

• It’s possible that social support may lead to better health behaviors.

Stress Reduction Techniques

• A common and highly effective technique people use to combat stress is exercise.

  • Exercise of long and short duration is beneficial for both physical and mental health

  • Physically fit individuals are more resistant to the adverse effects of stress and recover more quickly from stress than less physically fit individuals.

  • One reason exercise may be beneficial is because it might buffer some of the deleterious physiological mechanisms of stress

• Herbert Benson, a cardiologist, developed a stress reduction method called the relaxation response technique.

  • The relaxation response technique combines relaxation with transcendental meditation, and consists of four components:

    • Sitting upright on a comfortable chair with feet on the ground and body in a relaxed position

    • a quiet environment with eyes closed

    • repeating a word or a phrase—a mantra—to oneself

    • passively allowing the mind to focus on pleasant thoughts

• Biofeedback: a technique that uses electronic equipment to accurately measure a person’s neuromuscular and autonomic activity—feedback is provided in the form of visual or auditory signals.

  • The main assumption of this approach is that providing somebody biofeedback will enable the individual to develop strategies that help gain some level of voluntary control over what are normally involuntary bodily processes

14.5 The Pursuit of Happiness

Happiness

• Some psychologists have suggested that happiness consists of three distinct elements: the pleasant life, the good life, and the meaningful life.

  • The pleasant life: realized through the attainment of day-to-day pleasures that add fun, joy, and excitement to our lives.

  • The good life: achieved through identifying our unique skills and abilities and engaging these talents to enrich our lives

  • The meaningful life: involves a deep sense of fulfillment that comes from using our talents in the service of the greater good: in ways that benefit the lives of others or that make the world a better place.

  • In general, the happiest people tend to be those who orient their pursuits toward all three elements.

• Happiness: an enduring state of mind consisting of joy, contentment, and other positive emotions, plus the sense that one’s life has meaning and value.

  • The definition implies that happiness is a long-term state rather than merely a transient positive mood we all experience from time to time.

• The average person in the world tends to be relatively happy and tends to indicate experiencing more positive feelings than negative feelings.

• Life satisfaction usually increases the older people get, but there do not appear to be gender differences in happiness.

• Family and other social relationships appear to be key factors correlated with happiness.

• Happy people tend to have more friends, more high-quality social relationships, and stronger social support networks than less happy people.

• Increases in income are associated with increases in happiness, but income within societies appears to correlate with happiness only up to a point.

• Education shows a positive (but weak) correlation with happiness, but intelligence is not appreciably related to happiness.

• The relationship between religiosity and happiness depends on societal circumstances.

  • Nations and states with more difficult living conditions tend to be more highly religious than societies with more favorable living conditions.

    • Among those who live in nations with difficult living conditions, religiosity is associated with greater well-being; in nations with more favorable living conditions, religious and nonreligious individuals report similar levels of well-being.

• To the extent that people possess characteristics that are highly valued by their culture, they tend to be happier.

• People are often poor at predicting the intensity and duration of their future emotions

• People are often incorrect when estimating how our long-term happiness would change for the better or worse in response to certain life events.

• We eventually adapt to changing emotional circumstances in our lives.

  • When an event that provokes positive or negative emotions occurs, at first we tend to experience its emotional impact at full intensity. Eventually, we adjust to the emotional new normal; the emotional impact of the event tends to erode, and we revert to our original baseline happiness levels.

• Long-term happiness levels can and do change for some people.

• Measuring happiness and well-being at the societal level over time may assist policy makers in determining if people are generally happy or miserable, as well as when and why they might feel the way they do.

  • Resolutions about political and social issues might be best considered with people’s happiness in mind.

Positive Psychology

• Seligman helped establish positive psychology

• Positive psychology: an area of study that seeks to identify and promote those qualities that lead to greater fulfillment in our lives.

• Qualities that help promote psychological well-being are linked with a range of favorable health outcomes, mainly through their relationships with biological functions and health behaviors.

• Positive affect: pleasurable engagement with the environment.

  • The characteristics of positive affect can be brief, long-lasting, or trait-like.

  • Positive affect is associated with greater social connectedness, emotional and practical support, adaptive coping efforts, lower depression, and longevity and favorable physiological functioning.

  • Positive affect also serves as a protective factor against heart disease.

• Optimism: a generalized tendency to expect that good things will happen; a tendency to view life’s stressors and difficulties as temporary and external to oneself.

Flow

• Flow: a particular experience that is so engaging and engrossing that it becomes worth doing for its own sake

• It’s usually related to creative endeavors and leisure activities, but it can also be experienced by workers who like their jobs or students who love studying.

• When people experience flow, they become involved in an activity to the point where they feel they lose themselves in the activity.

  • They effortlessly maintain their concentration and focus, they feel as though they have complete control of their actions, and time seems to pass more quickly than usual

• Flow is considered a pleasurable experience, and it typically occurs when people are engaged in challenging activities that require skills and knowledge they know they possess.

• Flow suggests that finding an activity that you are truly enthusiastic about, something so absorbing that doing it is reward itself is perhaps the real key.