CHAPTER 17 Health, stress and coping

LEARNING OUTCOMES

After studying this chapter, you should be able to:

17.1 describe the biopsychosocial model of health behaviour and distinguish between the different theories of health behaviour

17.2 describe the barriers to health promotion and preventive health

17.3 describe the major sources of stress

17.4 discuss the nature of the relationship between stress and health

17.5describe the major strategies for coping with stress.

CONCEPT MAP

Health, stress and coping

Health psychology

• Health psychology is devoted to understanding psychological influences on how people stay healthy, why they become ill and how they respond when they do get ill.

• The biopsychosocial model of health recognises that social and psychological variables in addition to biological underpinnings laid the foundation for health and illness, and guides the field of health psychology today.

• Theories of health behaviour include the health belief model, the protection motivation theory of health, the theory of reasoned action and the theory of planned behaviour.

• The transtheoretical model is an integrative approach to behavioural change where people work through five stages of change: precontemplation, contemplation, preparation, action and maintenance.

• In spite of knowledge of the negative health consequences that may befall them, people continue to engage in a number of health-compromising behaviours, including poor diet, smoking, alcohol abuse and high-risk sexual behaviours.

• Four barriers to health promotion: individual barriers, family barriers, health system barriers and community and cultural barriers.

• Image can be a major factor in health behaviours — most people are quite concerned about what others think of them and modify their behaviours to create an impression they think will be favourable.

The future of health psychology

• Health psychology will continue to progress in the years to come. Health psychologists will probably persist with the promotion of positive health behaviours and help people to cope better with the consequences of ill health and other health-compromising behaviours.

• An individual’s health and wellbeing are multidimensional, with environmental, social, biological, lifestyle, spiritual, vocational, societal and socioeconomic factors all interacting.

Stress

• Stress refers to a challenge to a person’s capacity to adapt to inner and outer demands.

• Stress is a psychobiological process, with both physical and psychological components and consequences. For example, Selye’s general adaptation syndrome consists of three stages: alarm, resistance and exhaustion.

• Stress is also a transaction between the individual and the environment, in which the individual perceives the demands of the environment tax or exceeds their psychosocial resources. For example, Lazarus’s model identifies two stages in the process of stress and coping: primary appraisal and secondary appraisal.

• Events that often lead to stress are called stressors. For example, life events are stressors that require adaptation and change.

• Psychoneuroimmunology examines the influence of psychosocial factors on the functioning of the immune system.

• Stress can affect physical health in two ways: directly, by weakening the immune system, and indirectly, by leading to behaviours that weaken the body’s defences or lead to exposure to pathogens.

Coping

• Coping reflects the ways people deal with stressful situations.

• Problem-focused coping involves changing the situation (e.g., deal with the stressor itself); emotion-focused coping aims to regulate the emotion generated by a stressful situation (e.g., alter thoughts about the situation, and/or alter the unpleasant emotional consequences of stress).

• Members of minority groups who, for generations, experience a ceiling on their economic prospects because of discrimination sometimes develop a low-effort syndrome in which they seemingly stop making the kinds of active efforts that might alleviate some of their hardships.

• Social support refers to the presence of others in whom a person can confide and from whom the individual can expect help and concern. Post-traumatic growth involves a person creating a new narrative and renewed philosophy about life by transforming the way they see the impact of a traumatic experience.