Ch Health Stress and Coping

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					Ch 15 Health Stress and Coping
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Health is greatly affected by stress.
Periods of stress are commonly followed by illness.

    1. Occurs whenever a challenge or threat forces a person to adjust or adapt.
    2. Also a behavioral factor that directly affects personal well being.

Basic personal habits and behavior affect health
       We need to minimize risk factors
       Need to increase health promoting behaviors

Personality type affects amount of stress people experience

Behavioral Principles
      Unhealthy behavior - causes ½ of deaths
      Behavioral – medications manage medical problems
              Pain control
              Coping with illness
      Behavioral Risk Factors-
              Increase risk of death from disease
              Lifestyle diseases
              45% of all deaths are due to unhealthy behavior = tobacco, drinking, drug
              use and lack of exercise
      Risk Factors:
              High level of stress
              Increased blood pressure
              Cigarette smoking
              Abuse of alcohol + drugs
              Unsafe sex
              Exposure to toxic substances
      Disease Prone Personality
              Chronic depression (less exercise, eat poorly, sleep poorly)
              Frequently ill
         Not Disease Prone (generally good health)
                Intellectually resourceful
                Non hostile
         Health Promoting behaviors
                No excessive drinking
                No tobacco
                No overeating

         Early prevention
                 Prevent smoking
                 Refusal skills training
         Life skills training- help cope with day to day stress
                 Stress reduction
                 Decision making
                 Self control
                 Social skills
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         Stress is a major behavioral Risk Factor if prolonged + severe

         Stress results as a matter of how we perceive events + react to them

         Definition of stress
                 Stress is the mental + physical condition that occurs when a person must
                 adapt to the environment
         Examples- work, marital problems, financial problems, travel, sports, dating

       Good stress, events and issues are seen as challenges, and potentially rewarding

Stress reactions-
        Autonomic nervous system,  arousal, with emotion

Stressor – an event that challenges or threatens a person

Pressure- when a person must meet urgent external demand or expectations

Variables to stress:
Control (less stress) and lack of control causes stress (less controls = more stress)
       Unpredictable events add to stress

Emotional shocks- intense, repeated, pressure, unpredictable, uncontrollable=stress is
Nursing, teaching, police, social work and Burnout
Burnout- being physically, mentally + emotionally drained
1. Emotional Exhaustion- fatigued tense +apathetic; feeling all used up
2. Cynicism- detached from job, ―I don’t give a damn.‖
3. Feeling of reduced personal accomplishment
       Helpless, hopeless or angry, poor work performance
4. Burnout is the opposite of –Job engagement (work seen as important and meaningful,
To Prevent Burnout
       Adjust workload
       Keep social support (support gives encouragement)

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Appraising Stressors
Ultimately- stress is determined by how a situation is perceived

Richard Lazarus- researcher said
Making the appraisal of a situation=
1. Primary Appraisal – Q: Am I ok or in trouble?
       a. Decide if the situation is relevant or irrelevant positive or negative
2. Secondary Appraisal- Q: What can I do about this situation?
       a. Assess resources
       b. Choose a way to meet threat or challenge
       c. Coping with threats=coping

Coping with Threats:
1. Problem-focused coping (control is the issue)
      a. Need to manage or alter the distressing situation

2. Emotion-Focused Coping: (when there is no control of the situation)
     a. People try to control their emotional reactions to the situation

Extreme Situations + Responses
Frustration-negative emotional state occurs when people are prevented from reaching
desired goals (2 types)

1 External Frustration- outside force or individual impedes progress toward a goal (flat
       Delays success
       Can be social obstacles = people
       Non-social = objects

       Frustration increases- as strength of blocked motive increases-frustration
       2. Personal Frustration- personal characteristics
Reactions to Frustration:
       Aggression- any response with intent of harming a person or object
               Most frequent response to frustration
               *Persistence to frustration- varied efforts to overcome frustration

       Displaced Aggression
              Focusing aggression toward some-other person or object- whoever or
              whatever is available
              Redirection – usually to a safe, less likely to retaliate direction

              *Chains of displacement
       *Hostility and violence are largely due to displaced aggression
       *Scapegoating- available sources blaming
       Withdrawal or Escape, Avoidance

Conflict- a person must choose between contradictory desires, needs and motive demands

1. Approach-Approach Conflicts (weak conflict)
       Two positive choices
       Two desirable alternatives
2. Avoidance-Avoidance Conflicts (difficult to resolve)
       Choice between 2 negative undesirable alternatives
       Based on personal needs or bias
3. Approach-Avoidance Conflicts (difficult to resolve)
       People are attracted to
       +                       same goal or activity

       fear + attraction—could result in ambivalence= mixed positive and negative

Multiple Conflicts- neither complete positive or negative options
AKA- double approach-avoidance- each alternative has positive + negative qualities
Psychological Defense
Psycho-dynamic-Freud identified

Anxiety- comes with threatening situations
Tense, uneasy, apprehension, worried, vulnerable
Emotion-focused coping = defense mechanism helps us reduce anxiety

Defense Mechanism (definition)
Any mental process used to avoid, deny, or distort sources of threat or anxiety
Help us keep from being overwhelmed by immediate threats

          (basic) protecting oneself from unpleasant reality by refusing to accept it or
          believe it

       Holding memories away from unpleasant reality by refusing to accept it or believe

Reaction Formation:
       Impulses held in check by exaggerating opposite behavior – I hate you- but act
       over protective

       Returning to earlier less demanding situations

        Unconscious process- protects us from anxiety to see out own faults in others
        Exaggerates negative traits in others
        Directs attention away from personal failings

       Making excuses
       Justifying behavior by giving rational but false reasons
       Can be reasonable and convincing but false

     Over achieving in one area to compensate for failures in another area
     Defense against feelings of inferiority
     Overcoming a weakness
     Going to great lengths to do so

                 Working off frustrated desires (especially sexual desires) through socially
                 acceptable activities
                 Rechanneling sexual energy into productive behavior
Learned helplessness:
      An acquired- learned inability to overcome obstacles and avoid aversive stimuli
      Major element of depression
      Learning to passively endure
      Occurs when events seem to be uncontrollable especially after repeated failures
      Unpredictable and unavoidable punishment

       Leads to depression with feelings of learned helplessness, feelings of
       powerlessness, lowered aggression, decreased activity, loss of apetite, loss of sex
       drive, despondency, hopelessness…

Other Defense Mechanisms
Since Freud first described the original defense mechanisms, other researchers have
continued to describe other methods of reducing anxiety. Some of these defense
mechanisms include:

Acting out –The individual copes with stress by engaging in attention-seeking behavior to
try and get notice that they crave. (School children trying to be class clown)

Affiliation – Involves turning to other people for support. (co-dependent behavior when
one feels he/she can’t cope by self)

Passive-aggression – Indirectly expressing anger. (teen silently resents chores; puts
dishes in washer, but does sloppy job and bangs plates around—easier for parent to take
charge of chore)

Avoidance – Refusing to deal with or encounter unpleasant objects or situations. (dislike
certain people at school and doesn’t join a club they’re in order to avoid contact with

Altruism – Satisfying internal needs through helping others.

Humor – Pointing out the funny or ironic aspects of a situation.

Psychosomatic illness:
      Psychological factors contribute to actual body damge
      Not hypochondrias Examples: can be caused by stress

    Dyspepsia- stomach pain- not an ulcer     Heart disease        Sexual dysfunction
    Eczema                                    Head, neck ache
    Hives                                     Back ache
    Migrane headache                          Indigestion
    Rheumatoid arthritis                      Chronic diarrhea
    Hypertension                              Fatigue
    Colitis                                   Insomnia
Type A personality                            Type B Personality
      High risk of heart attack               These people tend to be productive under
      Hard driving                            stress.
      Ambitious                               They are very much relaxed, patient and
      Highly competitive                      have a lot of self control.
      Achievement oriented                    One of the type B personality traits is that
      Persistent                              these people do not get irritated or angry
      Time urgency                            easily.
      Anger                                   They are less competitive and their
      Hostility                               competitiveness is often productive with
      Very rigid in attitudes                 good intentions.
                                              They rarely tend to be aggressive or
       These people are also prone to heart   frustrated.
       diseases because of the tensions,      People belonging to type B personality are
       stress and worrying attitude.          also very much tolerant and flexible who
                                              can change in order to adapt to situations
                                              and changes.
                                              These people do not get hyper if their time
                                              is wasted and do not mind waiting in
                                              queues or wait to get their work done.
                                              Relaxation, enjoyment, fun comes very
                                              naturally to them. They spend their free
                                              time socializing, shopping or having a good
                                              They are very calm as compared to their
                                              highly stung counterparts (type A). People
                                              of type A personality often wish they were
                                              working rather than spending their time in
                                              leisure and the type B personality traits are
                                              just the opposite.
                                              People of B type personality tend to plan
                                              things in advance before executing them.

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