stress by pengxiang


									Chapter 12: Stress, Coping,
        and Health
       The Relationship
  Between Stress and Disease

• Contagious diseases vs. chronic
  – Biopsychosocial model
  – Health psychology
    • Health promotion and maintenance
    • Discovery of causation, prevention, and
  Stress as an Everyday Event
• Major stressors vs. routine hassles
  – Cumulative nature of stress
  – Cognitive appraisals
      Social Readjustment Rating Scale
     Event         M value         Event          M value

 Death of spouse    100       Child leaves          29
 Divorce             73       In-law trouble        29
 Marital             65       Begin/end school      26
 Jail term           63       Spouse begins         26
 Marriage            50       Trouble with boss     23
 Fired at work       47       Work changes          20
 Retirement          45       Change in             20
 Pregnancy           40       Sleep habit           16
      The death of a spouse is a severe stressor
           leading to serious depression

Percent of
seriously    20
 widows                                              Widowed
   and       10
                                                     Not widowed
                   2 months    7 months        13 months
                  Number of months since death of a spouse
Stress and Health

           • Frustration
                – When serious or prolonged, becomes
                  major source of stress
           • Conflict
                – Two or more motives cannot be
                  satisfied because they interfere with
                  one another
                    •   Approach-approach conflict
                    •   Avoidance-avoidance conflict
                    •   Approach-avoidance conflict
                    •   Multiple approach-avoidance conflict
Figure 12.2 Types of conflict
Responding to Stress Emotionally

• Emotional responses
  – Annoyance, anger, rage
  – Apprehension, anxiety, fear
  – Dejection, sadness, grief
  – Positive emotions
• Effects of emotional arousal
  – The inverted-U-hypothesis
Stress and Health

      • Pressure
           – Arises from threats of negative events
      • Environmental conditions
           – Aspects like temperature, air pollution,
             noise, and humidity can be sources of
           – Visits for psychological problems were
             higher during days of high air pollution
           – More emergency visits for depression
             during cloudy, humid days
Stress and Health

             General Aspects of Stress
           • People feel stress and react to it
                – React to stress as a whole – both
                  psychological and physiological
                – Psychological and bodily reactions to
                  stress are highly similar
Emotion and Physiology
           Autonomic nervous system controls
                 physiological arousal
        Sympathetic                    Parasympathetic
     division (arousing)               division (calming)
        Pupils dilate        EYES       Pupils contract
         Decreases      SALIVATION         Increases
         Perspires           SKIN            Dries
         Increases      RESPIRATION       Decreases
        Accelerates         HEART           Slows
          Inhibits         DIGESTION       Activates
       Secrete stress      ADRENAL         Decreases
         hormones          GLANDS         secretion of
 Emotion - Lie Detectors

 Polygraph
   machine commonly used in attempts to detect
   measures several of the physiological
    responses accompanying emotion
     perspiration
     cardiovascular
     breathing changes
Emotion - A Polygraph
Emotion - Lie Detectors

 Control Question
   Example- Up to age 18, did you ever
    physically harm anyone?
 Relevant Question
   Example- Did [the deceased] threaten to
    harm you in any way?
 Relevant > Control --> Lie
Emotion - Lie Detectors

                  50 Innocents
                  50 Thieves
                    1/3 of innocent
                     declared guilty
                    1/4 of guilty
                     innocent (from
                     Kleinmuntz &
                     Szucko, 1984)
                                             Stress and the
  outflow                                    body’s response:
                                             Flight or fight?

                           Adrenal gland

              Cortisol     Norepinophrine
Figure 12.5 Brain-body pathways in stress
       Responding to Stress
• Selye’s General Adaptation
  – Alarm
  – Resistance
  – Exhaustion
• Brain-body pathways
  – Adrenal gland and catecholamines
  – Pituitary gland and corticosteroids
Stress and Health

             General Aspects of Stress
       Psychological reactions     Physical reactions
          – Changes in emotions,   – General
            motivations,             Adaptation
            cognitions               Syndrome
          – Anxiety                  • Alarm reaction

          – Depression               • Resistance stage
                                     • Exhaustion stage
          – Anger, irritability
                                   – Healthy and
          – Change in appetite
                                     unhealthy aspects
            and interest for sex
                                     of GAS
                       Changes in resistance during the three
                       stages of general adaptation syndrome
                        First stress reaction
                        Second stress reaction
Resistance to stress

                                                          Normal level

                       Alarm reaction            Resistance stage        Exhaustion stage
Stress and Health

      • Stress, depression, the GAS, and
        immune system
           – Immune system
           – Stress and depression reduce
             effectiveness of immune system
           – As one ages, effects of stress are stronger
           – Psychological treatments such as stress
             management can restore immune system
           – High levels of depression common when
             undergoing stress
Stress and Health

        Factors Influencing Reactions
                   to Stress
      • Prior experience with stress
      • Developmental factors
           – Impact of stress and age when occurring
      • Predictability and control
           – Usually events less stressful when
             predictable due to perception of having
             some control
           – Lack of perceived control has significant
             health consequences and ill effects
Responding to Stress Behaviorally

• Coping
• Styles of coping
  – Learned helplessness
  – Frustration-aggression hypothesis
  – Self-indulgence
  – Defensive coping
  – Constructive coping
Stress and Health

                     Social Support
      • Social support acts as buffer against
           – Persons with good social support are less
             likely to react to negative life events with
             depression, anxiety, and health problems
           – Ability to get it off your chest is therapeutic
             (being ill less often) BUT there are risks
             associated with this behavior (revealing
             one’s personal information to others)
Stress and Health

                    Type A Personality
               • Highly competitive, hard-driving;
                 ambitious in work, sports, and games
               • Works hurriedly, rushing with sense of
                 urgency, multitasks
               • Workaholic, no time off
               • Perfectionist and demanding
               • Speaks loud or explosively; often
                 hostile, aggressive, angry with others
Stress and Health

       Personal Factors in Reactions
                 to Stress
     • Cognitive factors
           – Perceptions: people think and interpret things
     • Personality characteristics
           – Important influence on health consequences
           – Type A personality
                • Associated (indirectly linked) with increased risk
                  of coronary heart disease
                • Psychotherapy can reduce hostility
   Stress and Physical Health

• Psychosomatic diseases
• Heart disease
  – Type A behavior—three elements
    • strong competitiveness
    • impatience and time urgency
    • anger and hostility
  – Emotional reactions and depression
• Stress and immune functioning
  – Reduced immune activity
Stress and Health

       Personal Factors in Reactions
                    to Stress
      • Gender differences
           – Women more likely to have lasting
             reactions to traumatic events; at more risk
             for exposure
           – Marriage and committed relationships have
             health benefits
                •   Social buffer against stress
                •   Live healthier, longer lives on average
                •   Loss of spouse affects men more
                •   Maybe marriage is choice of healthier people
Stress and Health
       Personal Factors in Reactions
                 to Stress
      • Gender differences
           – Fight-or-flight important to both sexes
           – Men more likely to use fight-or-flight
           – Women more likely to tend-and-befriend
                • Creates alliances for future if reoccurrence
                • Average response to workplace stress
                    – Mothers more nurturing to children
                    – Fathers more grouchy or withdrawn
Figure 12.6 Anger and coronary risk
Stress and Health

                     Coping with Stress
                • Effective coping
                    – Removing stress – make
                    – Cognitive coping with
                    – Managing stress reactions
                • Ineffective coping
                    – Withdrawal
                    – Aggression
                    – Self-medication
                    – Defense mechanisms
Stress and Health

             Changing Health Patterns
      • Learning to relax
           – Progressive relaxation training
      • Eating right, exercising, and
        following doctor’s orders
           – Improve eating habits
                • Diets and balanced meals
           – Regular aerobic exercises – keep fit
           – Medical compliance – prescribed
Figure 12.8 The prevalence of smoking in the United States
Stress and Health

                     Safety Management
    • Prevention
         – Disease and illness
         – Accidents; major cause of disability and death
              •   Be alert, cautious
              •   Use seat belts in vehicles
              •   Don’t drink and drive
              •   Workplace safety and training
                    – Use of safety equipment
Stress and Health

        Benefits of Health Psychology
      • Positive health practices
            – Moderate or no use of alcohol
            – Sleep 7 to 8 hours per night
            – Never or rarely eating between meals
            – Being near or at ideal weight for your height
            – Regular physical exercise
            – Never smoking cigarettes
            – Eating breakfast almost every day
         Reactions to Illness

• Seeking treatment
  – Ignoring physical symptoms
• Communication with health care
  – Barriers to effective communication
• Following medical advice
  – Noncompliance

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