Stress, Health, and Coping

Characteristics of Stressful Events

  • Stress: Experiencing events perceived as endangering well-being.
  • Stressors: Events that cause stress.
  • Stress responses: Reactions to stressors.
  • Behavioral medicine/health psychology: Study of how social, psychological, and biological factors contribute to illness.
  • Traumatic events: Situations of extreme danger outside usual experience (e.g., disasters, accidents, assaults).
    • Reactions: Survivors may experience:
      • Initial stun and disorientation.
      • Passivity and compliance.
      • Anxiety, apprehension, and repetitive storytelling.
    • Sexual abuse: Can lead to long-lasting emotional distress.
  • Common Events:
    • Controllability: Uncontrollable events are more stressful.
      • Perception of control reduces stress, even without exercising it.
    • Predictability: Unpredictable events are more stressful.
      • Warning signals allow for preparatory processes and reduce stress.
    • Major Changes in Life Circumstances: Any life change requiring readjustment can be stressful.
      • Holmes and Rahe's Life Events Scale measures stress based on life changes.
    • Internal Conflicts: Unresolved issues or incompatible goals can cause stress.
      • Examples: independence vs. dependence, intimacy vs. isolation, cooperation vs. competition, expression of impulses vs. moral standards.

Psychological Reactions to Stress

  • Reactions range from exhilaration to anxiety, anger, discouragement, and depression.
  • Anxiety: Common response to stressors.
    • Post-Traumatic Stress Disorder (PTSD):
      • Symptoms: Detachment, reliving trauma, sleep disturbances, concentration difficulties, overalertness, and survivor guilt.
      • Can develop immediately or years later.
      • Culture and gender interact to influence vulnerability to PTSD.
      • Traumas caused by humans are more likely to cause PTSD than natural disasters.
  • Anger and Aggression: Frustration can lead to aggression.
    • Frustration-aggression hypothesis: Blocked goals induce aggressive drive.
    • Displacement: Aggression may be directed toward an innocent person or object.
  • Apathy and Depression: Withdrawal and apathy can deepen into depression.
    • Learned helplessness: Experience with uncontrollable negative events can lead to apathy and depression.
  • Cognitive Impairment: Stressors can impair cognitive function.
    • Difficulty concentrating and organizing thoughts.
    • High emotional arousal and distracting thoughts.

Physiological Reactions to Stress

  • Fight-or-Flight Response: Body's mobilization to attack or flee.
    • The liver releases extra sugar, and hormones stimulate conversion of fats and proteins into sugar.
    • Heart rate, blood pressure, and breathing rate increase, muscles tense, and nonessential activities are curtailed.
  • Neuroendocrine Systems:
    • Sympathetic System: Increases heart rate and blood pressure and dilates pupils.
      • Stimulates adrenal medulla to release epinephrine and norepinephrine.
    • Adrenal-Cortical System: Signals pituitary gland to secrete adrenocorticotropic hormone (ACTH).
      • ACTH stimulates adrenal cortex, resulting in the release of hormones (cortisol).
  • General Adaptation Syndrome (Selye):
    • Alarm: Body mobilizes to confront a threat.
    • Resistance: Organism attempts to cope with the threat.
    • Exhaustion: Organism depletes its physiological resources.
  • Physiology of PTSD:
    • Physiological reactivity to trauma reminders.
    • Differences in brain activity (anterior cingulate gyrus and amygdala).
    • Potential damage to the hippocampus.
    • Lower resting levels of cortisol.
  • How Stress Affects Health:
    • Allostatic load: Wear and tear on the body from chronic stress.
    • Physical disorders: Ulcers, high blood pressure, and heart disease.
    • Impaired immune system.
  • Coronary Heart Disease (CHD):
    • Narrowing of blood vessels supplying the heart muscles.
    • Risk factors: high blood pressure, high serum cholesterol, diabetes, smoking, and obesity.
    • Demanding jobs with little control increase risk.
  • Immune System:
    • Psychoneuroimmunology: Study of how stress affects the immune system.
    • Stress affects the immune system's ability to defend the body.
    • Uncontrollable shock has a greater effect on the immune system.
  • Health-Related Behaviors:
    • Stress can lead to unhealthy behaviors (e.g., smoking, poor diet, lack of exercise).

Psychological Factors and Stress Responses

  • Psychoanalytic Theory: Unconscious conflicts cause stress responses.
  • Behavioral Theory: Individuals learn to associate stress responses with certain situations.
  • Cognitive Theory: Optimism and hope help respond to stress.
    • Pessimism linked to higher blood pressure and lowered immune system functioning.
  • Hardiness: Resistance to stress, characterized by
    * commitment, control, and challenge.
  • Finding Meaning: Finding positive changes in trauma can aid coping.
  • Type A Pattern: Hostile, aggressive, impatient individuals.
    • Increased risk for coronary heart disease.
    • The level of hostility is a better predictor of heart disease than overall Type A behavior.

Coping Skills

  • Coping: Process of managing stressful demands.
    * Problem-focused coping and emotion-focused coping
  • Problem-Focused Coping: Addressing the specific problem directly.
    * Define, generate alternative solutions, weigh the costs and benefits, choose and act.
  • Emotion-Focused Coping: Alleviating emotions associated with the stressful situation.
    * Behavioral (exercise, drugs, support) and cognitive strategies (setting aside, reinterpretating).
  • Social Support: Seeking emotional support from others.
  • Avoidant Coping: Denying negative emotions for short term reduction of stress.
  • Rumination: Dwelling on negative emotions without action.

Managing Stress

  • Behavioral Techniques:
    • Biofeedback: Receiving information about physiological state and altering it.
    • Relaxation Training: Techniques to deeply relax muscles and focus thoughts.
    • Exercise: Aerobic exercise lowers heart rate and blood pressure in response to stress.
  • Cognitive Techniques:
    • Cognitive Behavior Therapy: Identifying stressful situations and altering coping methods.
  • Modifying Type A Behavior with cognitive and behavioral techniques.

Seeing Both Sides: Is Unrealistic Optimism Good for Your Health?

  • Unrealistic Optimism Can Be Bad for Your Health:
    * People are unrealistically optimistic about future risks.
    * College students smoke illusioning themselves they will quit.
  • Unrealistic Optimism Can Be Good for Your Health:
    * Unrealistic optimism leads people to practice better health habits.
    * It is tied to good coping strategies.
    * Scientists also realizing that optimism may create or be associated with a bodily state conducive to health as well as to rapid recovery from illness.
    * People are often especially vulnerable to illness during intensely stressful times. But this seems to be less true of optimists.