Stress, Coping, & Health

Biopsychosocial Model

 Physical illness caused by interactions

between biological, psychological, and
sociocultural factors
 Biology operates in a psychosocial
context
Health Psychology

 Focuses on how psychosocial factors

relate to promotion and maintenance of
health, and the causation, prevention
and treatment of illness
Stress

 Any circumstances that threaten (real or

perceived) one’s well-being, and
subsequently tax one’s coping abilities
 Subjective in nature (e.g., public
speaking, flying, being supervised)
 Seriousness of impending surgery
unrelated to subjective stress
Types of Stress

1 Frustration
2 Conflict
3 Change
4 Pressure
Frustration

• Occurs in any situation where pursuit of

a goal is thwarted
• Can’t get what you want
• traffic jams to unrequited love
• Unrealistic expectations and frustration
Conflict

 Faced with two or more incompatible

options, motivations or impulses
 Freud
 Kurt Lewin (1935)
– approach-approach
– avoidance-avoidance
– approach-avoidance
Conflict

 Approach-approach
 choice between 2 attractive goals
 win-win situation
 least stressful
Conflict

 Avoidance-avoidance
 choice between 2 undesirable goals
 lose-lose
 quit miserable job vs. unemployment
 highly stressful
Conflict

 Approach-avoidance
 Choice to pursue a single goal that has
both attractive and undesirable qualities
 Promotion = pay raise + increased
responsibility
 produces vacillation - back and forth
behavior, indecision
Change

 Any noticeable alterations in life

circumstances that require readjustment
 not obviously negative events
 changes in relationships, work,
finances, etc can be stressful, even
when welcomed
Change

 http://www.cygni.org/scales/social_readj
ustment_rating_scale.htm

 People with higher SRRS more

vulnerable to variety of physical
ailments than lower scorers
Pressure

 Expectations or demands that one

behave a certain way
 Pressure to succeed at work, to publish,
to be cordial, etc
 Pressures to conform to expectations of
self or others
 More strongly related to measures of
mental health than SRRS and others
Responses to Stress

 Emotional (annoyance, anger)

 Physiological (racing pulse)
 Behavioral (yelling, aggression,
avoidance)
Emotional Responses

 More likely unpleasant than pleasant

 Associated with negative mood
 Dependent on cognitive appraisal
 Event --> self-blame --> guilt, sadness
 Common reactions include: annoyance,
anger, ragte, apprehension, anxiety,
fear, dejection, sadness, grief, shame,
envy, disgust, jealousy
Emotional Responses

 Emotional response is motivating

(reinforcing, punishing)
 Extreme emotional arousal can interfere
with coping and performance
 Yerkes-Dodson Law (inverted U
hypothesis)
 optimal arousal dependent on task
complexity
Physiological Response

 Fight or flight: physiological reaction to

threat
 autonomic nervous system mobilized for
attack or escape
 evolutionary value
 current adaptive value?
General Adaptation Syndrome

 Hans Selye
 noticed that animal physiological
responses to stress were similar
regardless of stressor
 stress reactions are non-specific
 coined the term stress
General Adaptation Syndrome

 Model of body’s stress response

1 Alarm
2 Resistance
3 Exhaustion
• If stress can’t be overcome, body’s limited
coping resources become depleted
• diseases of adaption
Behavioral Responses

 Coping: Active efforts to master, reduce,

or tolerate demands created by stress
 may be positive or negative
 Individuals exhibit styles of coping that
are consistent across situations
Aggression

 Frustration-aggression hypothesis
 not inevitable
 context specific
 displacement
 catharsis
Self Indulgence

 Excessive consummatory behavior

 shopping, smoking, drinking, eating,
internet
Defensive Coping

 Defense mechanisms: unconscious

reactions that protect individual from
adverse emotions (eg, anxiety, guilt)
 shield from stress-eliciting events
 self-deception, distortion of reality
 Commonly unhealthy - avoidant
Adaptive/Constructive Coping

 Relatively healthful efforts that

people make to deal with stressors
1 Confronting problems directly
• task relevant
• action oriented
• rational consideration of options
Adaptive/Constructive Coping

2 Based on realistic appraisal of stress &

coping resources
3 Recognizing and inhibiting potentially
disruptive emotional reactions
Impact of Stress on Psychology

 “Choke” effect
 Burnout - physical, mental, emotional
exhaustion attributable to longer-term
exposure to stressful situations
– fatigue, weakness, low energy
– negative attitudes towards self, others,
work
– hopeless, helpless
Impact of Stress on Psychology

 Burnout - need to believe our lives/work

are meaningful, and our activities are
useful, important, etc
 “erosion of the spirit”
Post-traumatic Stress Disorder

 Exposure to traumatic event that

represented actual or threatened harm,
and response involved intense fear,
helplessness, or horror
 Hyperarousal
 Intrusive imagery
 Avoidant behavior
Impact of Stress

 Insomnia & sleep disturbance (e.g.,

nightmares)
 poor academic performance
 sexual problems
 substance abuse
 depression & dysthymia
Stress & Physical Health

 Psychosomatic disorders: physical

ailment with genuine organic basis that
are caused in part by psychological
factors (emotional distress)
 not imagined ailments
 hypertension, ulcers, migraines, rashes,
asthma
Type A Behavior

1 Highly competitive
2 impatient
3 angry & hostile

• Type B: easy going, relaxed, amicable

• Type A associated with coronary artery,
hypertension, premature mortality
Type A

 Double the risk vs. Type B

 May depend on other individual factors
 attributable to greater physiological
reactivity
 ups and downs tax cardiovascular
system
 create more stress for selves
 less social support & positive coping
Proximal effects of stress

 Stress as catalyst for heart attacks

 Stress management training improves
outcome with cardiac patients
 Depression and heart disease - cause
or effect?
 Depression - unhealthy behavior
Psychoneuroimmunology

 Arthritis, yeast infections, herpes, dental

disease, inflammatory bowel disease
 Stress depletes and/or suppresses
immune activity - vulnerability to
infection
 Student research - reduced immune
activity surrounding final exams
 same for recently divorced men
Stress Moderators

 Social Support
 students reporting greater social
support had higher levels of antibody re:
combat respiratory infections
 strength of relationship rivals cigarette-
cancer relationship
Stress Moderators

 Optimism - expectance of positive

outcome
 related to lower incidence of illness and
more effective immune functioning
 cope in more adaptive ways
 pessimists more likely to cope passively
 pessimism and self-blame
Stress & Health Impairing
Behavior
 Poor nutrition
 Sedentary lifestyle
 Substance abuse
 Smoking