PSY1011 Lecture Notes: Health, Stress & Coping

Health, Stress and Coping

• Lecturer: Dr Swati Mujumdar (swati.mujumdar@monash.edu)
• Prescribed Readings: Chapter 17
  • Health: 847-858; 875-880
  • Stress: 883-893
  • Coping: 893-898

Acknowledgement of Country

• Monash University acknowledges that its Australian campuses are located on the unceded lands of the people of the Kulin Nations and pays its respects to their Elders, past and present.

Learning Objectives

• Describe the biopsychosocial model of health behavior and distinguish between the different theories of health behavior.
• Describe the barriers to health promotion.
• Describe the major sources of stress.
• Describe the major strategies for coping with stress.

Health Psychology

• A field in which psychologists conduct and apply research aimed at promoting human health and preventing illness.
• Relating an understanding of the individual to the entire healthcare system.
• Focus:
  • How people stay healthy.
  • Why people become ill.
  • How people respond when they are ill.
• Goal: to help people understand the role they can play in controlling their own health and life expectancy.

The Biopsychosocial Model of Health

• Encompasses biological, psychological, and social factors.
  • Biological: Genetic vulnerabilities, drug effects.
  • Psychological: Temperament, IQ, coping skills, trauma.
  • Social: Peers, self-esteem, family relationships, family circumstances, school, social skills.
• Physical health and mental health interact within this model.

Wellbeing

• Wellbeing: a state of being comfortable, healthy, or happy.
• Holistic definition of mental and physical health:
  • Not merely the absence of disease or illness.
  • Reflects a combination of factors related to happiness and life satisfaction.
  • Multidimensional in nature.
• Interacts with social, biological, lifestyle, socioeconomic, environmental, spiritual, and vocational factors.

Enhancing Wellbeing

• Work-Life balance
• Exercise & nutrition
• Flexible hours
• Workplace safety
• Professional development & training
• Happy relationships
• Give, connect, take notice, help others
• Gut health – prebiotics, probiotics
• Gamification / Apps
• Mindfulness

Theories of Health Behaviour

• Health Belief Model: four factors- perceived susceptibility, optimistic bias, perceived seriousness & cues to action
• Theory of Reasoned Action: a socio-cognitive view incorporating an individual’s attitudes toward health behaviour and subjective norms
• Protection Motivation Theory of Health: includes the component of self-efficacy to the Health Belief Model
• Theory of Planned Behaviour: incorporates self-efficacy into the Theory of Reasoned Action
• Transtheoretical model: accounts for people may not change unless they are ready to do so

HEALTH BELIEF MODEL

• Perceived susceptibility: I have a family history of diabetes so I might be at risk at developing it
• Perceived severity: If I develop diabetes it can lead to other serious problems like kidney failure and heart disease
• Perceived benefits: Eating healthy and exercising can lower my risk of diabetes
• Perceived barriers: I don’t have time to exercise, and healthy food is expensive and time consuming to cook
• Cues to action: My doctor warned me that my blood sugar is on the higher side & I saw a health campaign on TV
• Self-Efficacy: I have started walking for 40 minutes daily and am learning to cook healthier meals.

Theory of Reasoned Action

• Focuses on beliefs, attitudes, normative beliefs, and subjective norms to predict intention and behavior.

Protection Motivation Theory of Health

• Self-efficacy: Our own belief of having the capacity to successfully change our behaviour

Theory of Planned Behaviour

• Based on three factors:
  • Personal attitudes
  • Subjective norms
  • Perceived behavioral control

The Transtheoretical Model

• Stages of Change:
  • Precontemplation (not ready)
  • Contemplation (getting ready)
  • Preparation (ready)
  • Action
  • Maintenance
  • Relapse

Barriers to Health Promotion

• Individual Barriers:
  • Lack of knowledge is rarely an explanation
  • Short-term rewards of health compromising behaviours
  • Negative effects of health compromising behaviours are often not immediate
  • Unrealistic optimism
  • Gender: men less likely to engage in health promoting behaviour
• Family Barriers
  • Health habits acquired in childhood
  • Genetics

Barriers to Health Promotion (cont.)

• Health System Barriers
  • Biomedical model: Doctors trained to focus on illness and not health
  • Lack of health insurance
  • Relationship between doctor and patient
  • Communication between doctor and patient
• Community, cultural and ethnic barriers
  • Norms of the community
  • Either promote or provide barrier to health-promoting behaviours
  • Disparities in health between Indigenous and non-Indigenous Australians (Close the Gap)
  • Rural and remote living (access to health services)

What is Stress?

• Internal process that occurs when we adjust to situations
• These situations are beyond our coping capacity
• Something that causes tension physically, mentally and emotionally
• Our body’s response to anything that requires attention
• Stress can be defined as a transaction (or process) emphasizing the relationship between the individual and the environment (Lazarus & Folkman, 1984)

Stress as a Biological Process

• Hans Selye – first person to describe GAS
• 3 stages
  • 1. Alarm Reaction: distress signal send to the hypothalamus glucocorticoids released adrenaline released rise in blood pressure/blood sugar levels (fight or flight response)
  • 2. Resistance: Recovery phase after fight or flight body eventually adapts signs include frustration, irritability, etc.
  • 3. Exhaustion: Prolonged or Chronic Stress all body resources drained and exhausted leads to fatigue, burnout, depression, etc.

General Adaptation Syndrome (GAS)

• Alarm stage
• Resistance stage
• Exhaustion stage

Stress as a Transactional Process

• Stress is a transaction between the individual and environment rather than a property of either alone
  • Primary Appraisal: decide if the situation is benign, stressful or irrelevant — and if stressful, what to do about it
  • Secondary Appraisal: evaluate options and decide how to respond, emotional forecasting
• Three types of stress: harm or loss, threat, challenge.

Stressors

• Psychological Stressors: Events/circumstances that challenge the adaptative capabilities of a person (traumas, life threatening experiences, illness, etc.)
• Physiological Stressors (reactions): Physical responses to stress due to imbalance in homeostasis in the body (rapid heart rate, fatigue, high blood pressure, etc.)
• Stressors: events or situations that create stress
  • Psychological
  • Physiological

Sources of Stress

• Life events
• Major stressors (e.g., death of spouse or child)
• Acculturative stress: adapting to new culture
• Catastrophes (natural disasters, war, torture)
• Daily hassles: irritating, frustrating, distressing demands that characterise everyday transactions

SRRS Scale (Holmes & Rahe, 1967)

• Social Readjustment Rating Scale; lists various life events and assigns them a numerical value based on their impact.
• Examples:
  • Death of spouse: 100
  • Divorce: 73
  • Jail term: 63
  • Marriage: 50
  • Fired at work: 47
  • Pregnancy: 40

Stress and Health

• Stress impacts psychological wellbeing and functioning (e.g., memory)
• Chronic stress leads to cell death and reduction in hippocampus size (involved with memory)
• Stress associated with structural and functional changes in brain – especially chronic stress
• Stress decreases functional ability of immune system and influences onset of infectious disease

Stress and the Immune System

• Psychoneuroimmunology looks at the influence of psychosocial factors on the functioning of the immune system
• Immune system: body’s surveillance system used to detect and eliminate disease-causing agents (virus, bacteria).
• Antibodies: protein molecules destroy foreign agents
• Acute and chronic stress reduces efficiency and availability of antibodies

Stress, Personality and Gender

• Optimism vs Pessimism
• Positive emotions
• Males and females react differently to stress
• No noticeable gender differences in children
• Personality types: Type A and Type B

Coping

• Coping (coping mechanisms): the way in which people deal with stressful situations
• Problem-focused: Person attempts to change the situation
• Emotion-focused: Person attempts to change thoughts or emotional consequences of the stressor
• Low-effort syndrome: tendency to exert minimal effort to escape stressful social and economic situations
  • Associated with minority groups and discrimination – fixed v/s growth mindset

Social Support

• Social support: the presence of others in whom one can confide and from whom one can expect help and concern protective against the effects of stress and is associated with:
  • lower levels of post-traumatic stress disorder
  • higher levels of post-traumatic growth (positive, transformative growth in response to trauma)
• Buffering hypothesis: social support makes people less susceptible to the effect of stress in the first place
• Emotional disclosure associated with physical and psychological health

Undergraduate Stress

• As a first year undergraduate student, what kind of stress do you face?
  • Assignment due dates
  • Exams
  • Making friends at university (more difficult for online students?)
  • Online classes
  • Understanding the unit
  • Financial stress
  • Balancing social life
• Any other stress??

Stressors (Activity)

• Know your Stressors:
  • Make a list of the situations or challenges that trigger your stress response
  • Write down some of the top challenges that you are facing right now
  • Evaluate these issues/challenges
    • Are they internal/originate from within?
    • Have they happened to you from outside?

Good Stress???

• Can stress be good?
  • EUSTRESS Helps us stay motivated and work towards our goals
    • A challenging workout, travelling to unfamiliar destinations, etc.

Coping with Stress

• What strategies do you use to cope with stress?
  • Do you develop a programme to help you cope?
  • Do you seek social support as a coping strategy?
  • Are you able to think rationally, understand the situation and then take steps to cope with stress?
  • Do you do yoga or meditation to help you relax?
• Any other measures that you use?

Developing a Programme

• Assessment
  • Identify the sources and effects of stress
  • List the stressors and stress responses
• Goal Setting
  • Decide which stressors are and are not changeable
• Planning
  • List the specific steps to be taken
• Action
  • Implement coping plans
• Evaluation
  • Look at changes in stressors and stress responses
• Adjustment
  • Alter coping methods to improve results, if necessary

Physical Coping Strategies (cont.)

• Exercise
• Meditation
• Yoga
• Progressive muscle relaxation training
• Eat healthy
• Time management