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Chapter 18

Stress, Coping, Adjustment, and

Health

Copyright ©2021 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education.
 Models of the Personality–Illness Connection

• Interactional model.
• Transactional model.
• Health behavior model.
• Predisposition model.
• Illness behavior model.

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 Interactional Model

• Objective events happen to a person, but personality factors

determine the impact of events by influencing a person’s ability to
cope.
• Personality moderates the relation between stress and illness and
affects coping responses.

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 Transactional Model 1

Personality has three potential effects.

• Can influence coping.
• Can influence how a person appraises the events.
• Can influence the events themselves.

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 Transactional Model 2

It is not the event itself that causes stress but how the event is appraised,
or interpreted, by the person.

People do not just respond to situations.

• They also create situations through choices and actions.

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 Health Behavior Model

Personality does not directly influence the relationship between stress

and illness.
• Instead, personality affects health indirectly through health-promoting
or health-degrading behaviors.

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 Predisposition Model

Associations may exist between personality and illness because of a third

variable, which is causing them both.

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 Illness Behavior Model

Personality influences the degree to which a person perceives and pays

attention to bodily sensations and the degree to which a person interprets
and labels sensations as illness.

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 The Concept of Stress

Stress is a subjective feeling produced by events perceived as

uncontrollable and threatening.

Stressors.
• Events that lead to stress.
• Common attributes.
• Extreme: Stressors produce a state of feeling overwhelmed.
• Threaten a goal, calling into question something important to
individuals.
• Perceived as uncontrollable.

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 Stress Response

Flight-or-fight response: Increase of sympathetic nervous system activity.

• Person is startled, heartbeat and blood pressure increase, and palms
and feet become sweaty.

General adaptation syndrome (GAS).

• Alarm stage: Fight-or-flight response.
• If stressor continues, the resistance stage begins.
• Body uses its resources at above an average rate, even though
fight-or-flight response has subsided.
• If stressor is constant, the person enters the stage of exhaustion.
• Person is susceptible to illness, because physiological resources
are depleted.

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 Major Life Events

Identified as both positive and negative events that are stressors.

People who experienced most stress are more likely to have a serious
illness over the next year.
• Subsequent experimental work suggests that people under chronic
stress deplete bodily resources and become vulnerable to infections.
• Current interpretation is that stress lowers the functioning of immune
system, leading to lowered immunity to infection and resulting illness.

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 Daily Hassles

• Major life events create stress but are infrequent.

• Daily hassles are the major sources of stress in most people’s lives.
• Research indicates that people with a lot of minor stress suffer more
from psychological and physical symptoms.

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 Varieties of Stress

• Acute stress.
• Episodic acute stress.
• Traumatic stress (For example, posttraumatic stress disorder
[PTSD]).
• Chronic stress.
• Stress has additive effects, and it accumulates in a person over time.

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 Primary and Secondary Appraisal

Stress is in the subjective reaction of a person to potential stressors.

According to Lazarus (1991), in order for stress to be evoked, two

cognitive events must occur.
• Primary appraisal.
• Person perceives an event as a threat to his/her goals.
• Secondary appraisal.
• Person concludes that he/she does not have resources to cope
with demands of the threatening event.

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 The Role of Positive Emotions in Coping with Stress: A
Closer Look

General hypothesis.
• Positive emotions and appraisals may lead to a lowered impact of
stress on health.

Three coping mechanisms are capable of generating positive emotion

during stress (Folkman & Moskowitz, 2000).
• Positive reappraisal.
• Person focuses on the good in what is happening.
• Problem-focused coping.
• Uses thoughts and behaviors that manage or solve an underlying
cause of stress.
• Creating positive events.
• Creating a positive time-out from stress.

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 Coping Strategies and Styles

• Attributional style.
• Dispositional optimism.
• Management of emotions.
• Disclosure.

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 Attributional Style 1

Answer to the question, “Where does the person typically place the
blame when things go wrong?”

Three dimensions of attribution.

• External versus internal.
• Unstable versus stable.
• Specific versus global.

Different measures.
• Attributional Style Questionnaire and Content Analysis of Verbatim
Explanations (CAVE).

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 Attributional Style 2

Attributional optimism (Peterson, 2000).

• People who make stable, global, and internal explanations for bad
events are termed pessimists, whereas people who make unstable,
specific, and external explanations for bad events are termed
optimists.

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 Dispositional Optimism

Dispositional optimism (Scheier & Carver, 2000).

• Expectation that good events will be plentiful and bad events will be
rare in the future.

Optimism predicts good health and health-promoting behaviors.

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 Management of Emotions 1

Some theorists suggest that emotional inhibition leads to undesirable

consequences.

Other theorists see emotional inhibition more positively.

Chronically inhibited emotion seems to come with certain “costs” to the

nervous system.
• Someone who characteristically inhibits emotional expression may
suffer effects of chronic sympathetic nervous system arousal.

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 Management of Emotions 2

• Emotions serve the function of communicating to others how we are

feeling.
• Research indicates that emotional expressiveness is good for our
psychological health and general adjustment.

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 Disclosure

• Pennebaker argues that not discussing traumatic, negative, or

upsetting events can lead to problems.
• Telling a secret can relieve stress and improve health.

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 Type A Personality and Cardiovascular Disease 1

Subtraits of Type A behavior.

• Competitive achievement motivation.
• Time urgency.
• Hostility.

Early studies of Type A found it was an independent risk factor for

developing cardiovascular disease.
• Conducted by physicians using a structured interview.

Later research used questionnaires.

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 Type A Personality and Cardiovascular Disease 2

• Studies using questionnaires are less likely to find relationships

between Type A and heart disease than studies using structured
interview.
• Structured interview gets at the lethal component of Type A.

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 Hostility

People high in hostility are likely to react disagreeably to

disappointments, frustrations, and inconveniences.

Studies have established that hostility is a strong predictor of

cardiovascular disease.
• Hostility is associated with systemic inflammation.

Brief hostility-management therapy can result in cost savings for hospitals

by reducing hospitalization expenses associated with coronary care.

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 How the Arteries Are Damaged by Hostile Type A
Behavior

Strong feelings of hostility and aggression produce the fight-or-flight

response.
• Person’s body suddenly pumps more blood, but through arteries that
are now constricted.
• Changes produce mechanical wear and tear on the artery walls.
• Stress hormones released into the blood may lead to artery
damage and subsequent buildup of fatty deposits on the artery
walls.

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 Summary and Evaluation

• Some psychologists study the link between personality and health.

• Personality influences health in many ways.
• Understanding why some personalities are more resistant to stress,
better able to cope, and better able to adjust is an important goal,
which can be applied practically.

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Copyright ©2021 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education.