Chapter 13
Health, Stress, and Coping

Health Psychology

Uses behavioral principles to prevent illness and death, and promote health

Behavioral medicine: Applies psychology to manage medical problems (e.g., asthma and diabetes)

Lifestyle diseases: Diseases related to health-damaging personal habits (e.g., strokes and lung cancer)

Behavioral Risk Factors

Actions that increase the chances of disease, injury, or premature death

Disease-prone personality: Personality type associated with poor health; person tends to be chronically depressed, anxious, hostile, and frequently ill

Ways to Promote Health and Early Prevention

Refusal skills training: Program that teaches young people how to resist pressures to begin smoking (can also be applied to other drugs)

Life skills training: Teaches stress reduction, self-protection, decision making, self-control, and social skills

Community Health Campaign

Community-wide education program that provides information about how to decrease risk factors and promote health

Role model: Person who serves as a positive example of good and desirable behavior

Wellness: Positive state of good health and well-being; more than the absence of disease

General Adaptation Syndrome
(GAS, Selye)

Series of bodily reactions to prolonged stress; occurs in three stages:

Alarm Reaction

Body resources are mobilized to cope with added stress

Stage of Resistance

Body adjusts to stress but at a high physical cost; resistance to other stressors is lowered

Stage of Exhaustion

Body’s resources are drained and stress hormones are depleted, possibly resulting in psychosomatic disease, loss of health, or complete collapse

Stress

Stress: Mental and physical condition that occurs when a person must adjust or adapt to the environment

Includes marital and financial problems

Eustress: Good stress

Stress reaction: Physical reaction to stress

Autonomic nervous system is aroused

Stressor

Condition or event in environment that challenges or threatens the person

Pressure: When a person must meet urgent external demands or expectations

Immunity

Immune system: Mobilizes bodily defenses, like white blood cells, against invading microbes and other diseases

Psychoneuroimmunology: Study of connections among behavior, stress, disease, and immune system

Stress Management

Use of cognitive behavioral strategies to reduce stress and improve coping skills

Progressive relaxation: Produces deep relaxation throughout the body by tightening all muscles in an area and then relaxing them

Guided imagery: Visualizing images that are calming, relaxing, or beneficial in other ways

Avoiding Upsetting Thoughts

Stress inoculation: Using positive coping statements internally to control fear and anxiety

Designed to combat negative self-statements (self-critical thoughts that increase anxiety and lower performance)

Coping statements: Reassuring, self-enhancing statements used to stop self-critical thinking

Signs and Symptoms of Ongoing Stress

Emotional signs: Anxiety, apathy, irritability, mental fatigue

Behavioral signs: Avoidance of responsibilities and relationships, extreme or self-destructive behavior, self-neglect, poor judgment

Physical signs: Excessive worry about illness, frequent illness, overuse of medicines

Burnout

Job-related condition (usually in helping professions) of physical, mental, and emotional exhaustion; has three aspects:

Emotional exhaustion: Feel “used up” and apathetic toward work

Cynicism: Detachment from the job

Feeling of reduced personal accomplishment

Appraising Stressors

Primary appraisal: Deciding if a situation is relevant or irrelevant, positive or threatening

Secondary appraisal: Assess resources and decide how to cope with a threat or challenge

Perceived lack of control is just as threatening as an actual lack of control

Threats

Emotion-focused coping: Trying to control one’s emotional reactions to the situation

Problem-focused coping: Managing or remedying the distressing situation

Traumatic stresses: Extreme events that cause psychological injury or intense emotional pain

Frustration

Negative emotional state that occurs when one is prevented from reaching desired goals

External frustration: Based on external conditions that impede progress toward a goal

Personal frustration: Caused by personal characteristics that impede progress toward a goal

Reactions to Frustration

Aggression: Any response made with the intention of harming a person, animal, or object

Displaced aggression: Redirecting aggression to a target other than the source of one’s frustration

Targets tend to be safer, less likely to retaliate

Scapegoating: Blaming a person or group for conditions they did not create; the scapegoat is a habitual target of displaced aggression

Escape: May mean actually leaving a source of frustration (dropping out of school) or psychologically escaping (apathy)

Conflict: Stressful condition that occurs when a person must choose between contradictory needs, desires, motives, or demands

Ambivalence

Anxiety

Feelings of tension, uneasiness, apprehension, worry, and vulnerability 

We are motivated to avoid experiencing anxiety

Freudian Ego Defense Mechanisms

Habitual and unconscious mental processes designed to reduce anxiety

Work by avoiding, denying, or distorting sources of threat or anxiety

If used in the short term, can help us get through everyday situations

If used in the long term, we may end up not living in reality

Freudian Ego Defense Mechanisms: Some Examples

Denial: Most primitive; refusing to accept or believe reality; usually occurs with death and illness

Repression: When painful memories, anxieties, and so on are unconsciously held out of our awareness

Reaction formation: Impulses are repressed and the opposite behavior is exaggerated

Projection: When one’s own feelings, shortcomings, or unacceptable traits and impulses are seen in others; exaggerating negative traits in others lowers anxiety

Compensation: Making up for a perceived weakness by focusing on a strength

Rationalization: Justifying personal actions by giving “rational” but false reasons for them

Learned Helplessness (Seligman)

Acquired (learned) inability to overcome obstacles and avoid aversive stimuli; learned passivity

Occurs when events appear to be uncontrollable

May feel helpless if failure is attributed to lasting, general factors

Depression

State of despondency defined by feelings of powerlessness and hopelessness

One of the most common mental problems in the world

Childhood depression is dramatically increasing

Some symptoms: Loss of appetite or sex drive, decreased activity, sleeping too much

Mastery Training

Responses are reinforced that lead to mastery of a threat or control over one’s environment

One method to combat learned helplessness and depression

How to Recognize Depression (Beck)

You have a consistently negative opinion of yourself

You engage in frequent self-criticism and self-blame

You place negative interpretations on events that usually would not bother you

The future looks grim

You can’t handle your responsibilities and feel overwhelmed

Stress and Health

Social Readjustment Rating Scale (SRRS): Rates the impact of various life events on the likelihood of contracting illness

Not a foolproof method of rating stress

Are positive life events (getting married, having a child) also stressful?

People also differ in their reactions to stress

Microstressors (Hassles)

Any distressing day-to-day annoyance

Acculturative Stress

Caused by many changes and adaptations required when a person moves to a foreign culture

Psychosomatic Disorders

Psychological factors contribute to actual illnesses (bodily damage) or to damaging changes in bodily functioning

Hypochondriacs: Complain about diseases that appear to be imaginary

Certain kinds of ulcers are not psychosomatic

Most common complaints: respiratory and gastrointestinal

Biofeedback

Applying informational feedback to bodily control

Aids voluntary regulation of activities such as blood pressure, heart rate, and so on

Helpful but not an instant cure

May help relieve muscle-tension headaches, migraine headaches, and chronic pain

Cardiac Personalities

Type A personality: Personality type with elevated risk of heart disease; characterized by time urgency and chronic anger or hostility

Anger may be the key factor of this behavior

Type B personality: All types other than Type As; unlikely to have a heart attack

Hardy Personality

Personality type associated with superior stress resistance

Sense of personal commitment to self and family

Feel they have control over their lives

See life as a series of challenges, not threats