Griffin Dugan

Lauren Graham

PSYCH 488

10/29/18

Content Review 1

1. Creating and ending habits

In class, we learned about the “formula” for changing one’s behavior to either stop a bad

habit or start an adaptive one. We differentiated between actions, which are behaviors we do

sometimes that are sensitive to outcomes and goal-driven, and habits, which are behaviors that

don’t consider the outcome and are basically done automatically/subconsciously in response to a

stimulus. In order to turn an action into a habit, one wants to identify an immediate short-term

reward given immediately after completing the action, and then do this pairing repeatedly. For

example, I’m planning on making working out on the weekends a habit by rewarding myself

with a treat immediately afterwards that is delicious while not undoing the calories I just burned.

To break a habit, one either has to eliminate or avoid the stimuli that cause that behavior, or

create alternative/adaptive behaviors that accompany the unavoidable stimuli. An example of

this for me is my tendency to eat when I’m bored, and I plan to start keeping a bottle of water

next to me to drink when I know I’m bored and not hungry. These two ideas are most important

to me because I currently have some bad habits I want to kick and good habits I want to start up,

and will no doubt have additional ones in the future. Knowing how to go about changing my

behavior to be healthier is essential for me because it puts the power in my hands, rather than

waiting on things to be given to me.

2. Coping strategies vs. resources

People’s psychological and physiological stress responses can be affected by strategies and

resources. On the one hand, coping strategies/processes are actions done in response to a

stressor. These are considered “mediators” because they are what come between a stressor and

the stress response. There are different types of coping strategies which vary in how they

respond to stressors, either by confronting the problem directly (problem-focused) or avoiding it

and controlling one’s emotional response to the stressor (emotion-focused). In contrast, coping

resources are the inherent parts of a person that affect their stress-response. Coping resources act

as moderators by impacting the strength of the relationship between the stressor and the

response. You can think of coping resources as “what you already have going for you”, and the

main types are optimism, self-efficacy, self-esteem, and social support. Differentiating coping

strategies and resources is important, because while coping strategies are context specific, coping

resources are more widely applicable. For example, when someone is stressed about a test, a

coping strategy might be studying (problem-focused) or watching TV (emotion-focused), and

both approaches have their strengths and weaknesses. In comparison, coping resources in the

case of a stressful test would be the overall feeling that you are capable of handling this test, and

that you have friends to support you if things go wrong. These coping resources are feelings and

mindsets one uses to perceive the situation, meaning they act as a sort of support net in the case

of any stressor. Understanding how to cultivate more coping resources while being able to

utilize varied kinds of coping strategies is essential to lowering the health impacts of stress,

which is why this concept is especially important to me. It inspires me to work on building up

my resources, so that everyday stressors have less of an impact on my general wellbeing.

3. Problem-focused vs. Emotional-focused coping

As discussed in the previous item, coping strategies can take on many different approaches in

how they reduce stress responses. One of the main differentiators between coping strategies is

whether they are problem-focused or emotion-focused. Problem-focused strategies are specific

to the stressor, and are aimed to lessen the strength of that specific stressor. One can think of this

as lowering the stress response by focusing on the stressor and how to eliminate/reduce it.

Examples would include studying for a hard test, making a schedule for a busy week, or asking

for help from a loved one. While problem-focused approaches can be helpful in certain

situations, they can be useless or even hurtful in situations where the person doesn’t have control

over the stressor, such as with the death of a loved one. In this case, many people turn to

emotion-focused coping strategies, which are instead aimed at the stress response regardless of

the specific stressor. Examples of this strategy would include eating, watching TV, shopping, or

exercise. Emotion-focused coping is often associated with distracting oneself from the stressor.

This can be helpful in uncontrollable situations, but in changeable situations this could be

considered avoiding the problem instead of confronting it. Furthermore, many emotion-based

coping strategies become unhealthy when done in excess, such as binge eating/exercising.

Interestingly a study done by Eaton and Bradley (2008) showed that women were much more

likely to engage in emotion-focused coping compared to men, while negative affect was

associated with specifically avoidance behaviors for both men and women. Keeping in mind the

strengths and weaknesses of each approach is very important so that one is able to use different

strategies depending on the situation and context. In my own life, I aim to create a balance

between these two approaches, so I can accept the things I cannot change, but deal with the

things I can.
4. Social support and social capital

Social support is the feeling and perception one has of belonging and having assistance and

acceptance from their community. The studies we’ve looked at have shown that feelings of low

social support result in more drastic and unhealthy stress responses to psychological stressors.

Conversely, one of the best coping resources to have is a feeling of social support and

community. As a study done by Lee and Goldstein (2015) shows, where this support comes

from impacts its stress-buffering effects, with support from friends and romantic partners being

more negatively associated with loneliness in comparison to familial support. Related to this

idea of feeling supported in one’s community is “social capital”, which is defined as the depth

and range of social resources available to someone in difficult times. Social capital can be

measured several ways, and having high social capital generally means experiencing lower levels

of crime, increased trust in neighbors, more volunteering, more community organizations, and

more voting. In summary, having social capital includes the feelings of safety, trust, and

community one has in their environment. This is an important concept for me because it

encourages me to continue seeking out social connections and support in college. I hate the

feeling of loneliness, and knowing that stress and loneliness go hand-in-hand is important for me

to remember as I strive to meet new people and form new and meaningful bonds.

5. What is Mindfulness?

Mindfulness involves being present in the current moment, rather than worrying about the

future or ruminating on the past. Through practices like meditation, mindfulness is meant to

ground someone in the current moment rather than having them continue to operate on auto-pilot

through life. Stopping auto-pilot allows one to greater appreciate nature and life itself.

Additionally, being mindful involves accepting your sensations and thoughts for what they are,
rather than trying to avoid or change anything. By taking the time to stop and reflect,

mindfulness allows an individual to better understand the patterns of their thoughts and

emotions, and differentiate between worry and reality. Mindfulness is increasingly being used as

a therapeutic intervention for people suffering from anxiety disorders. Outside of that clinical

setting, a study done by Delgado et al. (2010) showed that practicing mindfulness not only

helped nonclinical high-worriers to decrease reports of stress, but also to improve emotional

recognition and control regulation over physiological functions such as breathing rate.

Mindfulness is an important idea for me to take away from this class because while many

stressors are unavoidable and uncontrollable, I can control my mental response to said stressors.

Going forward, I hope to practice mindfulness when I notice my thoughts start to spiral with

worry, and remember instead to live one breath at a time.

6. Culture and Acculturation

One’s culture and its accompanying community and coping strategies can impact the effect a

stressor has on a person’s health. In fact, culture plays a large role in social support and capital,

as some cultures emphasize interdependence more than independence. For example, a study

done by Wang et al. (2010) showed how Asian-Americans are less likely to seek social support

out of a desire to maintain group peace, and are more likely to find kinship support to be less

helpful. However, immigration complicates the issue of culture’s mitigation of stress-response.

In particular, when someone immigrates to a new country and culture, they are left with several

options for acculturation. In biculturalism, the individual is able to maintain their original

culture while integrating aspects of the new one. With assimilation, the immigrant adopts the

new culture at the expense of their traditional culture. Similarly, separation involves keeping

one’s original culture and rejecting the norms and ideas of the new culture. Lastly,
marginalization occurs when the individual loses their old culture as a result of moving to a new

place, but is not able to be accepted into the new community’s culture. Unsurprisingly,

marginalization is associated with the worst health outcomes, as it lowers social support and

leaves the individual more vulnerable to stress-induced diseases. This concept of different

cultures dealing with stress and coping is important to me because as a resident of the Pacific

Northwest and a student at the University of Washington, I will continue to encounter people

from different backgrounds and cultures. Understanding the varied ways cultures deal with

stress, and recognizing the importance of having a cultural community, will help me to be a

better peer and friend for people who are experiencing stress.

7. Resilience in Coping

It is a fact that even when people are confronted with the same stressor or traumas, some

people are able to moderate their stress response to be more adaptive than others. The ability to

quickly bounce back after a major stressor is called resilience. The study we read about resilient

coping in the face of trauma shed some light on several urban myths. For example, even though

resilient style coping is often assumed to be a rare exception, it is actually the most common

response, and sampling error accounts for this misconception. Specifically, while there are

veterans who return from a traumatic combat zone with PTSD, many more of those veterans do

not go on to develop PTSD. More importantly, many people assume that it is common for

people to experience a delayed stress-response to a major stressor, when in actuality it’s quite

rare. This miscalculation means that we view resilient coping as merely a delayed form of

stress-response, and thus we pathologize resilience as something that needs to be treated.

However, not only is it wasteful to use counseling resources on these resilient people, but

through iatrogenesis, therapy can actually cause problems to be created for the resilient, because
they are taught that there is something wrong with their coping. This concept that resilient

coping is real and common is important for me, because it exemplifies how different people

handle stress/grief differently. It’s harmful to assume that everyone in my life should react to a

major stressor the same way. Instead, I should accept that people have different styles of coping,

and focus my attention on the people who are more clearly struggling.

8. Income inequality and “feeling” poor

In general, higher levels of income inequality in a region are associated with lower levels of

child well-being. Furthermore, people with low socioeconomic status are more likely to have

worse disease outcomes, even when healthcare is universal in a country. However, despite

popular belief, this difference in health outcomes is not due to a decreased level of average

education or an increase in health risk factors. Instead, a large part of the poor health outcomes

that come with being poor are associated with the stress of “feeling poor”. That is, when a poor

person is cognizant of the people who are living much more comfortable rich lives, they

experience an increased level of stress. They might find themselves feeling bitter at the

inequality, or guilty for not “working harder” to earn the same amount. That is why income

inequality is so positively correlated with poor health outcomes for the poor. In particular, the

conditions that poor people live in are usually low in social capital, meaning they experience

higher rates of crime as well as distrust of their neighbors. All these factors contribute to why

the stress that accompanies poverty can often be more influential than the poverty itself on health

outcomes. This idea is important to me because I am currently volunteering at Compass Housing

Alliance for this class, which helps homeless men. Learning about this helps explain to me a bit

more what these men are experiencing, not only from a financial level, but also psychologically.
Learning about how being poor affects health helps me to better understand the problems faced

by this community, so I can be of service during my volunteering.

References

Delgado LC, Guerra P, Perakakis P, Nieves Vera M, Reyes del Paso G, Vila J. (2010). Treating

chronic worry: Psychological and physiological effects of a training programme based on

mindfulness. Behavior Research and Therapy, 48, 873-882.

Eaton, R.J., & Bradley, G. (2008). The role of gender and negative affectivity in stressor

appraisal and coping selection. International Journal of Stress Management, 15, 94-115.

Lee, C.S., & Goldstein S.E. (2015). Loneliness, stress, and social support in young

adulthood: Does the source of support matter? Journal of Youth and Adolescence, DOI:

10.1007/s10964-015-0395-9

Wang S, Shih JH, Hu AW, Louie JY, Lau AS. (2010). Cultural differences in daily support

experiences. Cultural Diversity and Ethnic Minority Psychology, 16,413-420.

Content Review 2

1. Cognitive restructuring and maladaptive thoughts

Cognitive restructuring refers to the practice of identifying, challenging, and changing

maladaptive/irrational thoughts. Some examples of maladaptive thought patterns include mind

reading (assuming other people’s thoughts without evidence), all-or-nothing thinking (thinking

in terms of “always” or “never”), and disqualifying the positive (only focusing on the negative
aspects of a situation), along with others. Cognitive restructuring is done through a process of

identifying the situation, analyzing your mood and automatic thoughts, thinking up evidence for

and against those thoughts, and coming to a more balanced view of the situation. In regard to

stress, cognitive restructuring is very necessary because stress can exacerbate maladaptive

thinking. For example, brain research has found that uncontrollable stress results in higher

catecholamine release in the prefrontal cortex, which hinders neuronal firing and higher

cognition. Furthermore, that same release of catecholamines also strengthens the amygdala and

striatum, which leads the brain to reacting more reflexively rather than critically reflecting

(Arnsten 2015). This all suggests that experiencing stress, especially at chronic levels, can

hinder the prefrontal cortex from thinking rationally, and default our thoughts and behavior

instead to the more emotion-centered amygdala. This topic is very important to me because I

have struggled with maladaptive and irrational thoughts since I was young, starting with a

constant fear of my parents dying. Cognitive restructuring was necessary for me, because it

forced me to look at the facts: the probability of my parents suddenly dying was small, and

worrying about it did nothing to prevent it. Although I’ve done a lot of work to challenge these

maladaptive thought patterns and I have seen some success, I still do have the tendency to mind

read and overgeneralize things, especially in novel social situations. Learning about this topic

was one of my course goals because I am always looking for new ways to challenge the negative

voices in my head that tend to assume the worst.

2. Learned helplessness

Learned helplessness is typically seen as a prelude to depression (although not always), and it

occurs when the experience of many negative events outside of a person's perceived or actual

control leads to a general feeling of helplessness. People who experience learned helplessness
typically have abnormal activity occurring in the prefrontal cortex and the amygdala. In

particular, the parts of the prefrontal cortex responsible for critical thinking and problem solving

are less active, while the parts of the prefrontal cortex that send information to the amygdala are

more active. In turn, there is increased activity in the amygdala, the emotional/fear-driven part

of the brain. All of this abnormal activity results in a person viewing situations as bad and

uncontrollable, and so they feel helpless. As an example, if a person applies for a lot of jobs but

is constantly rejected from each position, they might develop a sense of learned helplessness that

results in them not even bothering to apply anymore because they see it as pointless. This

concept is important to me because I have friends who have experienced a sense of learned

helplessness after repeated rejections from college majors or jobs. In these instances, their

amygdala takes over and they start to feel like applying for things is a waste of time.

Understanding the process and brain activity involved with learned helplessness will better help

me to understand what my friends are going through, and encourage them to keep trying despite

what their mind is telling them. Learned helplessness is not permanent; it just takes the person

developing a more internal locus of control, and seeing that control in some aspect of their life.

3. Lifetime of Experiences Questionnaire

The Lifetime of Experiences Questionnaire (LEQ) is a measurement survey that looks at

how many “experiences” a person in their older age has had. Topics covered in the survey

include education level attained, social connection, hobbies, musical activity, sports/exercise,

travel, languages, occupations, and retirement. The survey is split into three stages of life: young

adulthood (ages 13-30), midlife (ages 30-65), and late-life (ages 65+). From all three stages, a

total is collected that is considered your LEQ score. In research done by Valenzuela et al. (2008)
in which 37 healthy adults were surveyed and their brains were scanned, they found that higher

LEQ scores were correlated with greater hippocampal volume and a lowered rate of hippocampal

atrophy in comparison to those with low LEQ scores. This would suggest that living a life filled

with more LEQ experiences results in healthier aging in the brain, especially since the

hippocampus is normally heavily affected by old age and stress. This topic is important to me

because it inspires me to seek out more life experiences. I am still young, so I have a lot of time

now to pursue new life activities that will result in me aging more gracefully. In particular, I

want to form more friendships with my peers, learn Spanish, pick up the guitar again, and

continue to earn my education. All of these would also be considered nourishing activities,

which are things I know I need to make more time for in my life in order to feel happier and

healthier.

4. Rumination

Rumination is a tendency of people with depression and/or anxiety to fixate and hyper-

focus on a negative thought, especially when they don’t want to. For example, someone who

receives some constructive feedback from their boss about a presentation may find themselves

thinking only about the negative feedback, and these thoughts may persist long after the person

goes home for the day. In the brain, a lowered amount/responsiveness to serotonin has been

associated with excessive rumination, which is one reason why selective serotonin reuptake

inhibitors (SSRIs) are commonly prescribed as an anti-depressant. Rumination and ways to

prevent it have been a topic for research for a while. For example, a recent study looked at social

anxiety disorder and pre-event rumination. In the study, the subjects (who all had social anxiety

disorder) were told they were to give a speech in four days, but half of them were instructed to

use detached mindfulness as a way to prevent rumination. Participants in the mindfulness group
reported reduced frequency, uncontrollability and distress in regards to rumination, and there was

no difference in actual performance (Modini & Abbot 2018). This suggests that mindfulness can

be used to prevent rumination and its associated distress, and that rumination does not have an

impact on event outcomes. Furthermore, a second study looked at rumination resulting from

either positive or negative feedback after participants gave an impromptu speech. The

researchers found that while those who received negative feedback tended to ruminate more, this

difference was eliminated when the participants exemplified high levels of self-compassion

(Blackie & Kocovski, 2018). Along with mindfulness, trait self-compassion is a potential

resource in reducing rumination. This concept is important to me because I have struggled with

rumination most of my life, whether it be focusing on worst case scenarios that never come true

or fixating on an ambiguous thing someone told me. I wanted to learn more about rumination

and how it can be prevented, which is why I chose to do research on this topic.

5. Dialectical Behavioral Therapy (DBT)

DBT was developed by University of Washington professor Marsha Linehan initially to treat

suicidal people with borderline personality disorder, but has now been adopted broadly for

people with other mental illnesses. Because it is designed primarily for suicidal people, DBT is

meant to help clients build a life they consider worth living, rather than just keeping them alive

in the life they hate. The D in DBT stands for “Dialect”, which refers to two opposing things

that can coexist despite seeming like they are mutually exclusive. The main dialect of DBT is

between acceptance and change, and it involves patients learning to accept the ways things are

for now while also continuously striving to change things in the future for the better. For

example, a therapist might validate a depressed person feeling the need to be isolated for a while,

but also encourage them to get active and interact with others. During DBT, there are several
modes of treatment for the patient, such as skill coaching/groups that aim to equip the client with

the ability to handle distress and emotion, individual psychotherapy, and in-vivo coaching where

the client can call their therapist at any time for guidance in a real-life situation. Another thing

that makes DBT unique is that therapists are involved in a consultation group with other DBT

therapists in order to receive advice and support to best help their clients. DBT usually involves

3-4 hours of work a week, but in line with developing a life worth living, it also makes sure to

keep clients involved with school, work, and friends. This concept is important to me because I

have an interest in going into counseling or clinical psychology. It is always interesting for me

to learn more about different treatment methods, including their strategies, strengths, and

weaknesses. No one treatment is perfect for every individual, so I know it’s important to have an

understanding of all the options a client can have.

6. Stress and the immune system

The immune system, both through acquired (specific antibodies) and innate (generalized

protectors found in mucous) immunity, helps to protect the body from foreign substances and

ward off diseases. However, when stress enters the equation, the immune system can get a bit

more complicated. For starters, the immune system is actually enhanced during the first few

minutes of the stress response. However, eventually the glucocorticoid levels reach a point

where the immune system is driven below its normal baseline. In this case, the glucocorticoids

prohibit the body from making new lymphocytes and kill the old lymphocytes. By pulling

lymphocytes out of circulation and weakening their sensitivity to messages from the body, high

levels of glucocorticoids can result in immune suppression. However, the lymphocytes that the

glucocorticoids kill are primarily older ones that don’t function well, and in this way the
glucocorticoids could be seen as “pruning” the immune system and strengthening it. On the

other hand, in cases of frequent transient stressors, the immune system can be enhanced so much

that a person can develop an autoimmune disease, where the immune system actually ends up

attacking the body. In this regard, high enough levels of glucocorticoids are actually helpful in

preventing autoimmune disease by lowering immune system activity. This is very clearly a

delicate balance in the body, whereby some stress can enhance the immune system, too much

can hurt it, and transient amounts of it can enhance it to the point of autoimmune disease. I

chose this concept as important because while I am generally a healthy person, lately I have been

coming down with random colds and sore throats. I think this is because I have been

experiencing enough ongoing stress from school and my internship that the glucocorticoids in

my system are actually harming my immune system and allowing disease to proliferate. I think

it’s important to be able to recognize when stress is taking a toll on the body in this way, because

it allows me to take a step back and evaluate the things I have on my plate. This has allowed me

to reprioritize what’s important to me, such as family and friends.

7. Stress, eating, and obesity

Stress has a pretty big impact on appetite and how we digest food. In general, CRH

inhibits appetite and works faster than cortisol, while cortisol is slower and stimulates appetite

(with preference for starchy, sugary, and fatty foods). When we experience a very sudden

stressor (such as a sudden death in the family), resulting in high CRH levels and low cortisol

levels, we feel a drop in appetite. Going along with this, during ongoing stressors (such as a

family member being sick in the hospital) that result in high CRH and high cortisol levels, we

experience ongoing appetite suppression as a result of CRH trumping the suppressive effects of
cortisol. However, an increase in appetite and over-eating occur when we experience repeated

intermittent stressors (such as constant assignments and deadlines during an academic quarter),

which result in moderate levels of CRH but high levels of cortisol. In regard to obesity in

particular, it’s important to note that not only do fatty foods inhibit the stress response, but

glucocorticoids also increase fat storage in the abdominal area as opposed to the gluteal. So,

when a person is experiencing repeated intermittent stressors, they are more likely to store food

near their abdomen and are more likely to seek out fatty foods. This all culminates in repeated

intermittent stress increasing the risk for obesity and obesity-related ailments such as

cardiovascular issues and diabetes. I find this concept important because it allows me to monitor

my change in appetite levels as a gauge for how stressed I am. The main problem in my life

recently has been frequent stressors increasing my appetite for unhealthy foods, so when I

recognize this is happening, I can try to address my stress in a healthier way such as meditation.

8. Exercise as coping

One fairly accessible coping strategy is exercise, particularly aerobic exercises such as

running or swimming. For example, aerobic exercise has been found to increase hippocampal

volume and prevent normal hippocampal atrophy associated with aging. The hippocampus is

very vulnerable to the glucocorticoids of the stress response, so using exercise as a coping

strategy during times of stress can help to alleviate volume loss. Additionally, exercise is

increasingly being pursued as an alternative to or supplement for antidepressants as a treatment

for depression. In general, exercise can result in better recovery from and less relapse into

depression. It is thought to have these effects by way of enhancing endorphins, boosting

norepinephrine levels, and helping the brain to grow new neurons. However, it is important to

note that these benefits seem to only be seen with 3-5 sessions a week of 45-60 minutes where
the heart reaches 50-85% of its max heart rate. Finally, the NPR podcast we listened to suggest

that synchronized dancing can actually work to increase pain tolerance. All of these results

indicate that exercise can be healthy not only for the body, but also for affect and the brain. This

concept is important for me because outside of walking to and from class, I don’t really make

exercise a normal priority in my life. I’ve never been interested in sports, so I always lacked that

team-based aerobic exercise. I’m trying to make it a goal on the weekends to go to the IMA for

an hour or so to do weights and go on a stationary bike, and learning about the specifics of how

exercise benefits me helps me to motivate myself to go.

References

Arnsten, A.F. (2015). Stress weakens prefrontal networks: molecular insults to higher

cognition. Nature Neuroscience, 18, 1376-1385.

Blackie, R. A., & Kocovski, N. L. (2018). Trait self-compassion as a buffer against post-event

processing following performance feedback. Mindfulness.

Modini, M., & Abbott, M. J. (2018). Banning pre-event rumination in social anxiety: A

preliminary randomized trial. Journal of Behavior Therapy and Experimental

Psychiatry, 61, 72–79.

Valenzuela, M. J., Sachdev, P., Wen, W., Chen, X., & Brodaty, H. (2008). Lifespan mental

activity predicts diminished rate of hippocampal atrophy. PloS one, 3(7), e2598.