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
• More Ways to 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
Fig. 13-9, p. 455
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
 APPRAISAL

Ask students to interview each other, making a list of activities

found to be “boring,” “relaxing,” “fun,” and “stressful.”
Most likely, many activities will be listed in different categories by
different people. Discuss perceptual differences in primary
appraisal
Table 13-3, p. 433
Fig. 13-3, p. 434
 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
 Reactions to Frustration
(cont)

• 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
FRUSTRATION AND VIOLENCE

In recent years, there has been an epidemic of kids killing kids. In

what ways might frustration have led to many of these acts of
violence?
How might children be taught to manage their frustration in ways
other than lashing out violently (and often fatally) at their peers?
Frustration and common
reactions to it.

Fig. 13-4, p. 436

Conflicts
 Approach-Approach Conflicts

• Having to choose between two desirable or

positive alternatives (e.g., choosing between
a new BMW or Mercedes)
 Avoidance-Avoidance Conflicts

• Being forced to choose between two negative

or undesirable alternatives (e.g., choosing
between going to the doctor or contracting
cancer)
– NOT choosing may be impossible or
undesirable
 Approach-Avoidance Conflicts

• Being attracted (drawn to) and repelled by the

same goal or activity; attraction keeps person
in the situation, but negative aspects can
cause distress
 Ambivalence

• Mixed positive and negative feelings; central

characteristic of approach-avoidance conflicts
• Can also be simultaneous attraction and
repulsion
Three basic forms of conflict. For this woman, choosing between pie and ice cream is a
minor approach-approach conflict; deciding whether to take a job that will require
weekend work is an approach-avoidance conflict; and choosing between paying higher
rent and moving is an avoidance-avoidance conflict. Fig. 13-5, p. 438
 Multiple Conflicts
• Double approach-avoidance conflicts: Each
alternative has both positive and negative
qualities
• Vacillation: When one is attracted to both
choices; seeing the positives and negatives
of both choices and going back and forth
before deciding, if deciding at all
• Multiple approach-avoidance conflicts: When
several alternatives have positive and
negative features
 What might come up in facing a
conflict?
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
 More Freudian Ego Defense
Mechanisms

• Projection: When one’s own feelings,

shortcomings, or unacceptable traits and
impulses are seen in others; exaggerating
negative traits in others lowers anxiety
• Rationalization: Justifying personal actions by
giving “rational” but false reasons for them
Think of someone you are mad at or frustrated with. Then, either
draw or write something that represents them on a piece of paper,
and when I say GO, tear it up into small pieces.
Do you feel better about the conflict situation?

DISPLACED AGGRESSION
Table 13-4, p. 441
 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
 Apply this to humans. In what ways can we
learn to be helpless?

In the normal course of escape and avoidance learning, a light dims shortly before
the floor is electrified (a). Because the light does not yet have meaning for the dog,
the dog receives a shock (noninjurious, by the way) and leaps the barrier (b). Dogs
soon learn to watch for the dimming of the light (c) and to jump before receiving a
shock (d). Dogs made to feel “helpless” rarely even learn to escape shock, much
less to avoid it. Fig. 13-7, p. 443
 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) always 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
– What cultural values would encourage Type A behavior?
Type B behavior? More hardy personalities? Why?
Put students in groups of six. One person stands in the middle, and
the other five put their arms around the waists of the people on
either side. The person in the middle has five minutes to break out
of the circle. Count backwards for the final 30 seconds.

Did you see students increase the vigor of their attempts during the
last few seconds?

Caution students against expressing their frustration aggressively.