Stress and Coping

Stress

Stress is a response to events that are perceived as challenging.
Stress is associated with health.

Measuring Stress

Stress can be measured through perceptions, life events, and minor events.
Life change: Brings changes that require considerable adaptation.
Social Readjustment Rating Scale (SRRS; Holmes & Rahe, 1967): Measures stress related to life changes.
- Positive or negative events.
- Life change can lead to illness.

Life Event Mean Value

Rank	Life Event	Mean Value
1	Death of spouse	100
2	Divorce	73
3	Marital separation	65
5	Jail term	63
6	Death of close family member	63
7	Personal injury or illness	53
8	Fired at work	50
9	Marital reconciliation	47
10	Retirement	45
11	Change in health of family member	45
12	Pregnancy	44
13	Sex difficulties	40
14	Gain of new family member	39
15	Business readjustment	39
16	Change in financial state	39
17	Death of close friend	38
18	Change to different line of work	37
19	Change in number of arguments with spouse	36
20	Mortgage over $10,000	35

Student Stress Scale

Event	Life Change Units
Death of a close family member	100
Death of a close friend	73
Divorce between parents	65
Jail Term	63
Major personal injury or illness	63
Marriage	58
Being fired from job	50
Failing an important course	47
Change in health of family member	45
Pregnancy	45
Sex problems	44
Serious argument with close friend	40
Change in financial status	39
Change of major	39
Trouble with parents	38
New girl - or boyfriend	38
Increased workload at school	37
Outstanding personal achievement	36
First quarter/semester of college	35
Change in living conditions	31
Serious argument with instructor	30
Lower grades than expected	29
Change in sleeping habits	29
Change in social activities	29
Change in eating habits	28
Chronic car trouble	26
Change in number of family get-togethers	26
Too many missed classes	25
Change of college	24

Daily Hassles

Daily hassles: Minor annoying events that require some degree of adjustment.
Daily hassles can lead to poorer health.

Hassles Scale (Kanner et al., 1980)

A scale to measure the severity of daily hassles, with options for:
- 1 = Somewhat severe
- 2 = Moderately severe
- 3 = Extremely severe
Examples of hassles:
- Misplacing or losing things
- Troublesome neighbors
- Social obligations
- Inconsiderate smokers
- Troubling thoughts about your future
- Thoughts about death
- Health of a family member
- Not enough money for clothing, housing, food, health care, or necessities
- Concerns about owing money or money for emergencies
- Someone owes you money
- Financial responsibility for someone who doesn't live with you
- Conserving electricity, water, etc.
- Smoking too much, use of alcohol, personal use of drugs
- Too many responsibilities
- Decisions about having children
- Non-family members living with you
- Planning meals, preparing meals
- Concerns about the meaning of life
- Trouble relaxing
- Problems getting along with co-workers
- Concerns about medical treatment
- Auto maintenance
- Fear of confrontation
- Feeling lonely
- Concerns about accidents
- Concerns about getting a loan/credit
- Having to wait in lines
- Too much time on your hands
- Unexpected company
- Too many interruptions
- Dislike co-workers
- Dislike current work duties
- Laid-off or out of work
- Concerns about retirement
- Care for pets
- Concerns about job security
- Housekeeping responsibilities
- Trouble making decisions
- Difficult customers/clients
- Physical appearance
- Difficulties getting pregnant
- Concerns about health in general
- Social isolation

Perceived Stress

Perceived stress: Subjective interpretations of events or life circumstances as stressful.
Negatively correlated with health.

Perceived Stress Scale (Cohen et al., 1983)

Measures the perception of stress over the last month.
Examples of questions:
- How often have you been upset because of something that happened unexpectedly?
- How often have you felt that you were unable to control the important things in your life?
- How often have you felt nervous and "stressed"?
- How often have you dealt successfully with irritating life hassles?
- How often have you felt that you were effectively coping with important changes that were occurring in your life?
- How often have you felt confident about your ability to handle your personal problems?
- How often have you felt that things were going your way?
- How often have you found that you could not cope with all the things that you had to do?
- How often have you been able to control irritations in your life?
- How often have you felt that you were on top of things?
- How often have you been angered because of things that happened that were outside of your control?
- How often have you found yourself thinking about things that you have to accomplish?
- How often have you been able to control the way you spend your time?
- How often have you felt difficulties were piling up so high that you could not overcome them?

How Does Stress Affect the Body?

Fight-or-flight (Walter Cannon): When animals perceive threatening situations, they respond with physiological reactions to prepare for fighting or running away.
- Stress response.

General Adaptation Syndrome (Hans Selye)

Body responds to threatening stimuli by arousal of system of defenses.
3 stages:
- Alarm: Body mobilizes to respond to stress.
- Resistance: Body adapts to stressor, but becomes weakened.
- Exhaustion: Physical resources are depleted in the process of trying to overcome or adjust to threat → Vulnerability to illness.

Stress and the Immune System

Caretakers at Risk

Tend-and-Befriend

Females’ responses to stress may be different than males’ (Taylor et al., 2000).
- “Tending” – caring for offspring.
- “Befriending” – affiliating in response to stress.

Models of Stress and Illness

Indirect effect model: Stress leads to unhealthy behaviors in an attempt to cope with stress.
Direct effect model: Stress leads to physiological reactions that lead to disease.

Personality – Type A

Type A behavior pattern (Type A personality): Competitive, hostile, tense.
- Link between “Type A” behavior pattern and heart disease.
Type B behavior pattern: Relaxed, less competitive.

Coping with Stress

Efforts to remove or diminish threat.
Problem-focused coping: Actions taken to change a stressful situation or reduce its effects.
Emotion-focused coping: Attempts to reduce distress.

Control

Greater control à lower stress response, better health.
Rodin & Langer, 1976 – plant study.
Perceived control: Beliefs about ability to affect one’s outcomes.
Perceived control à better health.

Optimism

Tendency to believe that one will generally experience good vs. bad outcomes.
Generally associated with positive health outcomes.
Exceptions:
- Unrealistic optimism
- Defensive pessimism

Social Resources

Social connection → better health
Mechanisms:
- Cognitive appraisal
- Health behaviors
- Psychoneuroimmunological pathways

% Died from All Causes

Connections	Men	Women
1. Least
II.
III.
IV. Most

Expressive Writing

Expressing emotional experiences
Lower stress, health benefits

Physical Activity

Reduces physical effects of stress
Reduces anxiety, depression
e.g., Hoffman et al., 2011

Minutes of Self-Reported Exercise per Week	HAM-D Score at 1 Year
50	10
100	8
150	6
200	7
250	4
300	2

Mindfulness

Focus on and awareness of current thoughts.
Accept and acknowledge the present.
Associated with positive health outcomes:
- Better immune functioning
- Lower blood pressure
- Lower stress levels

Religiosity

Religious attendance, finding strength and comfort from one's religious beliefs.
Religiosity à better health, lower risk of death.

Gratitude and Kindness

Expressing or noting gratitude → lower stress
Doing acts of kindness lower stress.