Stress and Health

Psychology
Dr. Kristi D. Wright
Psychology 101
 Agenda
 What Is Stress?
 How Do People Cope with
Stress?
 Health Psychology
What is Stress?
 What Is Stress?
 Selye, Holmes & Rahe, Lazarus
 Hans Selye:
 Stress is a nonspecific response to real or imagined
challenges or threats
 tension, discomfort, or physical symptoms
 A stressor is an environmental stimulus that affects an
organism, producing physical and psychological effects
such as tension and anxiety
 Stress can be bad (distress) or good (eustress)
Emergencies
 How do we respond to acute stress situations?
 Acute stress
 Chronic stress

Fight-or-flight response
 Walter Cannon argued that body prepares for “fighting” or
“fleeing” based on actions of hypothalamus and pituitary
gland

Tend-and-befriend response
 Shelley Taylor argued responses specific to women
 Tend to befriend others and broaden social networks
Stress activates
the Hypothalamic-
Pituitary Axis

Stimulates the
pituitary to secrete
hormone:
adrenocorticotropic
hormone (ACTH)

ACTH stimulates the

adrenal glands to
produce hormone:
cortisol
-enables to maintain
steady supply of blood
sugar (energy)
General Adaptation Syndrome
 proposed by Selye
 According to Selye,
people’s responses to a stressor are
similar, regardless of the type of
stressor
General Adaptation Syndrome
3 Stages
1. Alarm (an initial short stage)
2. Resistance (a longer period)
3. Exhaustion (the final stage)
What Is Stress?
 Lazarus says that stress is a result of a
cognitive appraisal of a situation
involving challenges or threats
 Lazarus and Stress
 people actively negotiate between
environmental demands (stressors) and
personal beliefs and behaviours
 Stress is the of an interaction of events
and evaluations of those events, what is
referred to as cognitive appraisal
Situations that Precede the
Development of Stress
 Catastrophes
 Catastrophes
 are events of massive proportion and destruction
 The severe stress caused by a catastrophe may result in
post-traumatic stress disorder (PTSD)
 Symptoms of PTSD include:
 Exposure (direct or indirect) to death, threatened death, actual
or threatened serious injury, or actual or threatened sexual
violence
1. Re-experiencing the event
2. Increased arousal
3. Avoidance
4. Alterations in Cognition and Mood
Residential Schools
 The Government of Canada designed a mandatory
educational system in which very young children were often
forcibly removed from their homes.
 150,000 children attended 132 federally-supported schools
 Many children and youth were inadequately fed, clothed and
housed. 
 All were deprived of the care and nurturing of their
parents,grandparents and
communities.
 First Nations, Inuit and Metis
languages and cultural practices
were prohibited in these schools. 
 It is estimated that upwards of 6,000
of these children died.

(Bull, 1991; Caldwell, 1967; Miller, 1996).  

 Long-term Effects
 Children suffered physical, sexual, and emotional
abuse in residential schools.
 There is long-term effects of these abuse
experiences.
 Wolfe et al. (2006) examined the long-term
effects of physical, sexual, and emotional abuse
in 76 Canadian men with substantiated claims
against a residential religiously-affiliated
institution for multiple and severe incidents of
sexual, physical, and/or emotional abuse during
childhood.
(Furniss, 1995; Knockwood, 1992; Haig-Brown, 1988; Johnston, 1988; Law Commission of Canada. 2000;
Sochting et al., 2007; Wolfe et al., 2006
Long-term Effects

 Results indicated:
59.2% presented with a current Axis I disorder
88.2% had had an Axis I disorder at some
point.
PTSD, alcohol-related disorders, and
depression had the highest prevalence rates
 Hassles
•– minor annoyances that strain our
ability to cope – can impact us as well

•More hassles are related to physical

health, depression, and anxiety

•Research shows this is true even when

major life events are controlled for
 Unhealthy Environments
 People in low socioeconomic groups often
live in environments that produce a large
number of hassles and stressors
 Urban pressure:
 a combination of crowding, pollution, noise,
commuting, stress, fear of crime and other hassles
unique to urban life that leads to stress
Discrimination
 Discrimination and unfair treatment are
factors in feeling stressed
 Ethnic minorities and immigrants
 Sexism
 Women are the targets of sexist discrimination
and harassment more than men and these
experiences produce stress
 LGBTQ+ experience discrimination because
of their sexual orientation
Personal Factors and Stress
 Personal Factors and Stress
 People who experience no catastrophe
and only minor environmental stress still
have stress from the workplace, personal
relationships, and time pressure
 Personal Factors and Stress
 High stress jobs tend to be one’s that impose
high demands on workers but give them little
latitude to make decisions
 Can you think of some jobs that fit this
description?

 Constraints in job, night shifts, overtime,

deadlines pressure, inadequately rewarded
 Personal Factors and Stress
 Burnout is a state of emotional and physical
exhaustion, lowered productivity, and feelings of
isolation, often caused by work-related pressure
Personal Factors and Stress
 Balancing family
commitments and work
can cause stress
 While marriage is one way
of having social support, it
can also be stressful
 Men vs. Women?
Response to Stress
 Responses to Stress
 Many researchers assume stress activates
physiological responses that can result in
disease
 cortisol & adrenalin

 Psychologists who study stress typically divide

the stress reaction into physiological and
behavioural components
 Physiology of Stress
 Physiologically, stress is characterized
by:
 arousal of the sympathetic nervous system
 promotes “fight or flight” response
 corresponds with arousal and energy generation,
and inhibits digestion
 blood flow to skeletal muscles enhanced
 dilates bronchioles of the lung, which allows for
greater oxygen exchange
 dilates pupils and relaxes the lens, allowing more
light to enter the eye.
 Behaviour and Stress
 Hebb has argued that effective behaviour
depends on a person’s state of arousal
 State of arousal:
 moderate level of stress may be desirable
 overarousal tends to produce disorganized,
ineffective behaviour
Stress and Health
Stress and Health
 Researchers have been interested in the link between stress and coronary
heart disease
 Complete or partial blockage of the arteries that provide oxygen to the heart
 #1 cause of death and disability in the US
 1 of 4 of main causes of death in Canada [cancer, diabetes, cardiovascular
disease (heart disease and stroke), and lung disease]
 Coronary Heart Disease (CHD)
 Factors associated with the development of CHD
 smoking
 high cholesterol
 high blood pressure
 family history of CHD
 diabetes
 low levels of vitamin D
 stress

 One of the first attempts to link behaviour and

heart disease is the study of Type A behaviour
 Heart Disease
 Type A behaviour is a pattern of
competitive, impatient, angry,
hostile behaviour
 Type B behaviour is exhibited by
people who are calmer, less
hurried, and less hostile
 Research on the components of
Type A have shown that hostility is
the most predictive of the
development of heart disease
 Infectious Disease
 Stress is related to the development of disease
through its effects on the immune system
 The study of this connection is called
psychoneuroimmunology (PNI)
 the interdisciplinary study of behavioural, neurological,
and immune factors, and their relation to the
development of disease
 Acne
 Acne typically an adolescent problem
 Increasingly seen in adults
 Research suggests
 stress has been shown to cause heightened levels of
glucocorticoids and androgens, which may initiate or
exacerbate acne flares
 relationship not clear cut
 appears to be a relationship between increasing stress
levels, androgen hormones and increasing levels of
acne found in women in fast paced jobs
Can your hair turn white from fear
(or a stressor)?
 Phenomenon of hair turning white from fright,
shock, grief or stress persists in the literature,
poetry, and medical journals
 first documented in 83 AD- 17 year old boy-due to
strenuous studying
 Autoimmune disorder
 Alopecia areata
 Attacks hair follicles, causing pigmented hair-black, brown,
red or brown to fall out-leaving gray and white
(nonpigmented hairs behind)
 Hair appears to have turned white or gray overnight
 Most people lose their all hair
 Stress can be a trigger for autoimmune disorders
How Do People Cope
with Stress?
 What Is Coping?
 Coping is the process by
which a person takes some
action to manage, master,
tolerate, or reduce
environmental and internal
demands that cause or
might cause stress
 Factors That Influence Coping
 People vary enormously in their ability to
cope with stressors
 Some of the variation is due to personal
resources that contribute to resilience
Personal resources (e.g., money, good health)
A sense of being in control is also a factor in
resilience
Social support
Gaining Control
 Behavioral Control
 Ability to do something to reduce the impact of a stressful situation
(i.e., problem-focused coping)
 Cognitive Control
 Ability to cognitively restructure or think differently about negative
emotions that arise in response to stressful events (i.e., emotion-
focused coping)
 Decisional Control
 Ability to choose among alternative courses of action
 Informational Control
 Ability to acquire information about a stressful event (i.e., proactive
coping)
 Emotional Control
 Ability to suppress and express emotions
Coping Strategies
 are techniques people use to deal with
the stress of changing situations
 Effective coping requires that people
have a variety of strategies and make
appropriate choices about when to use
them
 Emotion-Focused Coping
 Used often when source of stress is
outside one’s control
 Strategies used to reduce painful emotions
 include seeking social support, ignoring the
problem, distracting yourself
 Women seek social support more than men
 Problem-Focused Coping
 An active, task-oriented approach to
problem-solving is effective in many
domains
 People who use this strategy tend:
 have a more positive outlook
 fewer symptoms of illness
 better immune system functioning
 Proactive Coping
 involves anticipating a problem and
taking action to avoid it or decrease its
impact
Summary
 People must be reasonable in choosing
which situations to manage
 Proactive coping can prevent or
decrease stress, but requires effort
 Emotion-focused strategies need to be
chosen with care
Stress inoculation
 is a procedure of teaching people ways to
cope with stress and allowing them to
practise in realistic situations so they will
develop immunity to stress
Stress inoculation
 The first stage is conceptualization, in which people
develop an understanding of the stress process
 The second stage involves skills acquisition and
rehearsal
 The third stage is follow-through
 What Is
Health Psychology?
What Is Health Psychology?
 concerned with the use of psychological
principles to
 enhance health
 prevent illness
 diagnose and treat disease
 improve rehabilitation
4 behaviours to promote health
1. Stop Smoking!
2. Curb alcohol consumption
3. Achieve a healthy weight
4. Exercising
 Stop Smoking!

 Leading cause of preventable death in

Canada
 Only 5% of smokers who try to quit
succeed
 25-35% succeed when using methods
developed by health psychologists
 Curb Alcohol Consumption

 Heavy episodic drinking (binge drinking)

is five or more drinks on one occasion
for men, four or more for women
 Associated with increases in cancer,
liver problems, pregnancy
complications, and brain shrinkage
 Achieve a Healthy Weight
 Two-thirds of Americans are overweight, with
one third of those are obese
 Canada:
 18.3% of Canadian population are obese
 Projected: 21 per cent of Canadian adults will be obese
by 2019
 SASK leads country in obesity
 Stats Can- 45.9% of SK residents have a body-mass index
(BMI) of greater than 30
 Exercise is essential to loosing weight
 Achieve a Healthy Weight

 Obesity leads to higher risk for heart

disease, stroke, arthritis, cancer, and
diabetes
 As well as emotional and social
problems
 Teasing, depression, anxiety
 Tips to Achieve a Healthy Weight

 Avoid fad and crash diets (yo-yo effect)

 Exercise regularly
 Monitor total calories and body weight
 Eat properly (good fats, low salt, high fibre
foods)
 Get social support
 Control portion size
 Exercise
 Regular aerobic exercise has many benefits
 Lower blood pressure and risk for CHD

 Improve lung function

 Relieve the symptoms of arthritis

 Decrease diabetes risk

 Cut the risk of breast and colon cancer

 30 minutes several times a week is best

 According to the WHO:
deaths from HIV/AIDS has been
Preventing AIDS falling since the mid 2000’s and
stands at 1.2 million /year

 A focus on disease prevention led health

psychologists to be involved in the AIDS
epidemic
 High-risk behaviours expose a person to
the blood or semen of others who are
likely to have been exposed to the virus
 Successful AIDS interventions
Sources of HIV Infection in Adults
Public Health Agency of Canada (PHAC) 2014

MSM-Men who have sex with men

IDU-Injection drug use
HET-Endemic-Heterosexual contact - origin from an
HIV-endemic country
HET-risk-Heterosexual contact with a person at risk
NIR-HET-Heterosexual contact with no identified risk
Findings
 Exposure category was known (65.7%)
 48.8% due to MSM exposure
 29.2% due to heterosexual exposure
 13.1% due to injection drug use (IDU)
 10% due to heterosexual contact among people born in
a country where HIV is endemic (Het-Endemic)
 9.2% heterosexual contact with a person at risk (Het-
Risk)
 10% heterosexual contact with no identified risk (NIR-
Het
Barriers to Adopting Health-Promoting
Behaviours
 People are often stuck with habits that
increase their risks for disease and death
 Social circumstances and personal
attitudes make change difficult
 e.g. gender, culture

 Many believe risky behaviours will affect

others but not them, an optimistic bias
Seeking Medical Care
More likely to if More likely to not if
 judge it necessary  when the potential
 presence of painful, diagnosis is dreaded
persistent symptoms  male
 belief it will lead to a
cure
 female
Seeking Medical Care
 Most people in Western
countries hold beliefs
regarding illness and
disease that are
compatible with Western
medicine
 Others view health and
disease differently and
seek non-traditional
medical care
The Sick Role
 When people try to recover, they are
adopting a sick role
 This means taking specific steps to get
well, forgoing some responsibilities, and
realizing they are not at fault for their
illness
Compliance with Medical Advice
 People have trouble complying with all
types of medical recommendations
 Some problems originate in
communication problems between
patient and practitioner
 Other problems occur when patients
stop taking their medications because
they feel better
 Pain Management
 Severe and disabling pain can take three
forms:
1. Chronic pain (long-lasting and ever-
present)
2. Periodic pain (pain that comes and goes)
3. Progressive pain (ever-present,
increases in severity over time)
Pain Management
 Pain management works on two fronts:
1. attempts to reduce suffering, the
negative emotional experience that
accompanies pain
2. attempts to decrease the physical
aspect of pain
 Health Psychology Research at
the University of Regina
 Health Psychology Lab (Dr. Thomas
Hadjistavropoulos)
 PACSLAC
 Pain Assessment Checklist for Seniors
with Limited Ability to Communicate
(PACSLAC)
 Developers:
Drs. Shannon Fuchs-Lacelle and Thomas
Hadjistavropoulos
 an observational tool for assessment of
both common and subtle pain behaviors
 PACSLAC: 4 Subscales
1. Facial expressions
2. Activity/body movements
3. Social/personality/mood
4. Physiological indicators/eating
and sleeping changes/vocal
behaviors