Chapter 12: Stress, Coping,
and Health
The Relationship
Between Stress and Disease
• Contagious diseases vs. chronic
diseases
– Biopsychosocial model
– Health psychology
• Health promotion and maintenance
• Discovery of causation, prevention, and
treatment
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
home
Divorce 73 In-law trouble 29
Marital 65 Begin/end school 26
separation
Jail term 63 Spouse begins 26
work
Marriage 50 Trouble with boss 23
Fired at work 47 Work changes 20
Retirement 45 Change in 20
schools
Pregnancy 40 Sleep habit 16
change
The death of a spouse is a severe stressor
leading to serious depression
30
Percent of
seriously 20
depressed
widows Widowed
and 10
widowers
Not widowed
0
2 months 7 months 13 months
Number of months since death of a spouse
Stress and Health
Stress
• 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
Stress
• Pressure
– Arises from threats of negative events
• Environmental conditions
– Aspects like temperature, air pollution,
noise, and humidity can be sources of
stress
– 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
Reactions
• People feel stress and react to it
– React to stress as a whole – both
psychological and physiological
reactions
– 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
stress
hormones
Emotion - Lie Detectors
Polygraph
machine commonly used in attempts to detect
lies
measures several of the physiological
responses accompanying emotion
perspiration
cardiovascular
breathing changes
Emotion - A Polygraph
Examination
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
declared
innocent (from
Kleinmuntz &
Szucko, 1984)
Hypothalamus
Pituitary
Stress and the
Sympathetic
outflow body’s response:
Heart
Flight or fight?
Liver
Adrenal gland
Epinophrine
Cortisol Norepinophrine
Figure 12.5 Brain-body pathways in stress
Responding to Stress
Physiologically
• Selye’s General Adaptation
Syndrome
– Alarm
– Resistance
– Exhaustion
• Brain-body pathways
– Adrenal gland and catecholamines
– Pituitary gland and corticosteroids
Stress and Health
General Aspects of Stress
Reactions
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
• 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
linked
• 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
stress
– 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
differently
• 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
response
– 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
changes
– Cognitive coping with
reappraisal
– 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
medications
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
providers
– Barriers to effective communication
• Following medical advice
– Noncompliance