SHDH2039 Fundamental Psychology

for Health Studies

Stress & Health

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Lesson Plan
(A) Definitions of Stress

(B) The process & Major Types of stress

(C) Responses & Effects of stress

(D) Intervening variables

(E) Coping strategies & Stress Management

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(A) What is stress ?
• Think of & write down an incident that is
stressful to you
• _______________________________________
_______________________________________

• any circumstances that threaten or are perceived

to threaten one’s well being and that therefore,
require one’s coping ability (Weiten, 2008)

• the physical, emotional, cognitive, and

responses
behavioral ___________________to events that
are appraised as threatening or challenging

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(A) I. Stress: the concept
• may refers to both the stimulus (stressor)
or response (strain)

Stressors
• ________________ – events that cause
a stress reaction
• e.g. a major exam, a big date, conflict with
one’s boss, an earthquake

• Strains – physiological, psychological /

emotional, & behavioral responses

• Intervening variables – e.g., personality,

social factors, coping styles & strategies,
etc.

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Lesson Plan
(A) Definitions of stress & its basic nature

(B) The process & major types of stress

(C) Responses & Effects of stress

(D) Intervening variables

(E) Coping strategies & Stress Management

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(B) Overview of the Stress Process

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(B) III. Major Types of Stress
1) Life Change/Events– having to
adapt
• Holmes and Rahe (1967) – Social
Readjustment Rating Scale
(SRRS) – Life Change Units
• e.g. death of a spouse – 100,
divorce – 73, personal injury or
illness – 53, marriage 50,
pregnancy – 40, change in eating
habits – 15, etc.

2) Catastrophes – unexpected
traumatic events
wars
• e.g. natural disasters, ___________

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Holmes and Rahe’s Social Readjustment
Rating Scale Table 12.1 (TB: p.505)

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(B) III. Major Types of Stress
3) Daily Hassles – routine every day events
or minor annoyances of everyday life
• e.g. computer hanged when you are
hurrying for a paper
• accumulation of daily hassles was an even
better predictor of emotional & physical
health than were the major events in
people’s lives

4) Conflict– two or more incompatible

motivations or behavioral impulses
compete for expression
3 types of conflict:
• Approach-approach
• Approach-avoidance
• Avoidance-avoidance

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• In-class exercises
• Can you identify the type(s) of stress, such as daily hassle, catastrophe, life
change/event, and conflict (approach-approach, avoidance-avoidance, approach-
avoidance) involved in the cases provided?

1) Mary is late for appointment but is stuck in line at the bank. Daily Hassle
2) Denise wants to apply to a famous law school, but she hates to risk the possibility
of rejection. Conflict: Approach-avoidance
3) Susan was raped on her first date with an internet friend. Catastrophe
4) Joe has just graduated from business school and has taken an exciting new job.
Life Change/Event
5) John can’t decide to take an extremely low-pay job or to go on welfare.
Conflict: Avoidance- avoidance
6) Donald has just been fired from his job and needs to find another.
Life Change/Event

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Lesson Plan
(A) Definitions of stress & its basic nature

(B) The process & Major Types of stress

(C) Responses & Effects of stress

(D) Intervening variables

(E) Coping strategies & Stress Management

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(C) I. Responding to Stress
1) Cognitively - how we perceive and appraise the
demands being made of us
• Lazarus’s Cognitive Appraisal Approach
• TWO steps in determining if the potential stressor is a
threat:
1. Primary appraisal: our initial interpretation of an event
as irrelevant, positive (challenging), or stressful
(threatening or harmful)
• e.g. “What does this stressor and/ or situation mean?”, “How
can it influence me?”
2. Secondary appraisal: an evaluation of resources
available to cope with a stressor.
• e.g. “Do I have the resources to deal with the stressor?”

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(C) I. Responding to Stress

Lazarus’s Cognitive Appraisal Approach

1617_S1_CCN2039_Stress&Coping 14
(C) I. Responding to Stress
2) Physiologically – stress reactions are nonspecific

Hans Selye’s General Adaptation Syndrome (GAS)

• Alarm → Activates sympathetic nervous system
(fight-or-flight response).

• Resistance : body releases stress hormone to fight of

the stressor

• Exhaustion
____________: body’s resources are used up. We
function at less than normal. Wear and tear on the body
begin.

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Figure 11.1 General
Adaptation Syndrome
(Ciccarelli & White, 2015, p.467)

The diagram at the top shows

some of the physical reactions to
stress in each of the three stages
of the general adaptation
syndrome. The graph at the
bottom shows the relationship of
each of the three stages to the
individual’s ability to resist a
stressor. In the alarm stage,
resistance drops at first as the
sympathetic system quickly
activates. But resistance then
rapidly increases as the body
mobilizes its defense systems. In
the resistance stage, the body is
working at a much increased level
of resistance, using resources
until the stress ends or the
resources run out. In the
exhaustion stage, the body is no
longer able to resist as resources
have been depleted, and at this
point disease and even death are
possible.
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(C) I. Responding to Stress
3) Behaviorally
• Coping strategies – efforts that people take
to master, tolerate, reduce, or minimize the
effects of stressors
• maladaptive vs. adaptive/healthful
• defensive vs. constructive
• Frustration-aggression hypothesis
Striking out at others aggressively
• Giving up/ blaming oneself
• Self-indulgence e.g. eating, drinking,
smoking, shopping (more than usual)

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(C) I. Responding to Stress
3) Behaviorally
• Defensive Coping: Defense mechanisms
• mostly unconscious strategies that we use to defend
ourselves against threat, trauma, internal conflict (among
id, ego, superego), stress & anxiety

• Some major ego defense mechanisms:

• Denial
• Repression
• Displacement
• Regression
• Rationalization
• Projection
• Sublimation
____________________

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(C) II. Effects of Stress
1) Physical
• Psychosomatic
diseases
• physical ailments with a
genuine organic
basis that are caused
in part by
psychological factors,
especially emotional
distress…
• e.g. high blood
pressure, skin
disorders, asthma, and
migraine headaches
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Figure 11.3 Stress and Coronary Heart Disease (Ciccarelli & White, 2015, p.469)
The blue box on the left represents various sources of stress (Type A personality refers to someone who is ambitious, always working, and usually hostile). In addition to the
physical reactions that accompany the stress reaction, an individual under stress may be more likely to engage in unhealthy behavior such as overeating, drinking alcohol or
taking other kinds of drugs, avoiding exercise, and acting out in anger or frustration. This kind of behavior also contributes to an increased risk of coronary heart disease.

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Figure 11.2 Stress Duration and
Illness
In this graph, the risk of getting a cold (C) II. Effects of Stress
virus increases greatly as the months of
exposure to a stressor increase. Although
a stress reaction can be useful in its early 1) Physical
phase, prolonged stress has a negative
impact on the immune system, leaving ↓ Immune functioning
the body vulnerable to illnesses such as a & common cold
cold. Source: Cohen et al. (1998).

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(C) II. Effects of Stress
2) Behavioral & Psychological
Burnout
• ________________ – a workplace stress
• negative changes in thoughts, emotions,
and behavior as a result of prolonged stress
or frustration, resulting in both mental and
physical exhaustion

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(C) II. Effects of Stress
2) Behavioral & Psychological

• Psychological problems and

disorders
• e.g. sleep problems, depression,
eating disorders, etc.

Positive effects
• __________________
• build resilience / promote
personal growth /self-
improvement /

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Lesson Plan
(A) Definitions of stress & its basic nature

(B) The process & Major Types of stress

(C) Responses & Effects of stress

(D) Intervening variables

(E) Coping strategies & Stress Management

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(D) Intervening variables
1) Personality Type
• Type A - ambitious, competitive, extremely hardworking, impatience (i.e. easily annoyed)
and exceedingly time conscious, and tends to have high levels of anger and hostility.

• Type B - relaxed, patient, easygoing, less driven and competitive than Type A, and slow
to anger.

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(D) Intervening variables Source:
http://
www.lifewithoutlimbs.or
• Type C - pleasant but repressed person, g/about-nick
who tends to internalize his or her anger https://
www.facebook.com/
and anxiety and who finds expressing BBCCapital/videos/
637159856462791/
negative emotions difficult.

• Type D – “Distressed”: increased

negative emotions (anxiety, worries, etc.)

Hardy personality
• ____________________(Type H) - a
person who seems to thrive on stress.
- Tend to see life as a series of challenges
- Have a sense of personal commitment to
self, work, family, etc.,
- Increased sense of perceived control
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(D) Intervening variables

Figure 11.5 Personality and

Coronary Heart Disease (Ciccarelli &
White, 2015, p.473)
The two bars on the left represent men
with Type A personalities. Notice that
within the Type A men, there are more
than twice as many who suffer from
coronary heart disease as those who are
healthy. The two bars on the right
represent men with Type B personalities.
Far more Type B personalities are
healthy than are Type A personalities,
and there are far fewer Type B
personalities with coronary heart disease
when compared to Type A personalities.
Source: Miller et al. (1991, 1996).

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(D) Intervening variables
2) Other Factors
• Social Support System
↑ increase
• ___________________ immune
functioning & mental health
↓ decrease
• ______________________ likelihood of
mental disorders
• Perceived Control
- if the persons feels like the
stressful situation is controllable,
then stress may be reduced.
• Gender
《我係乜乜乜》社會實驗室：
• men / women – more likely to fight or 習得無力感 https://
confront a threat www.youtube.com/watch?
v=oHEkt1q6FPE
• men / women – more likely to seek
social support
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Lesson Plan
(A) Definitions of stress & its basic nature

(B) The process & Major Types of stress

(C) Responses & Effects of stress

(D) Intervening variables

(E) Coping strategies & Stress Management

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(E) I. Coping Styles & Strategies
1) Two types of Coping:
• behavioral & psychological strategies
• Problem-focused coping: coping strategies
that try to eliminate the source of a stress or
reduce its impact through direct actions.

• Emotion-focused coping: coping strategies

that change the impact of a stressor by
changing the emotional reaction to the
stressor.

• Which type of coping is better?

It depends…
e.g. Controllable vs. Uncontrollable
stressful events
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 Conclusion
1) The Biopsychosocial Model

2) Stress can have both positive & negative aspects

** Assigned Readings: Pastorino & Portillo – Ch. 12

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