chapter 13teachinginsanity.net/ap psych/unit 03/chp_13_stress.ppt.pdf · chapter 13 health, stress,...

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Table of Contents Exit

Chapter

13Health,

Stress, and

Coping


Key Terms

• Stress: any real or imagined threat to one’s well-being.

• Frustration: state in which the pursuit of one’s goals is thwarted.

• Conflict: when 2 or more incompatible motivations occur.

• Change: noticeable alteration in one’s life that require one to adjust their lives

• Pressure: Expectatrions or demands to behave in a certain way.

• Coping: mechanisms used to deal with all the above (like defense mechanisms)


Health Psychology and

Behavioral Risk Factors• Health Psychology: Uses behavioral principles to prevent illness 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


Health Psychology and

Behavioral Risk Factors (cont.)

• Behavioral Risk Factors: Behaviors 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

• Life Skills Training: Teaches stress reduction, self-protection, decision making, self-control, and social skills

• Role Model: Person who serves as a positive example of good and desirable behavior

• Wellness: Positive state of good health and well-being


Stress and Illness

� Leading causes of death in the US in 1900

and 2000

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Promoting Health

� Smoking-related early deaths40,000

30,000

20,000

10,000

0

33,348

1,686 1,135 556 202

Smoking Suicide Vehicle HIV/ Homicide

crash AIDS

Cause of death

Number

of deaths

per 100,000


The

Physiological

Effects of

Nicotine


But as smoking declines,

obesity increases� Trading risks


Obesity and Weight

Control� Obesity and mortality

18.5 18.5- 20.5- 22.0- 23.5- 25.0- 26.5- 28.0- 30.0- 32.0- 35.0- 40

20.4 21.9 23.4 24.9 26.4 27.9 29.9 31.9 34.9 39.9

Body-mass index (BM I)

Men Women

2.8

2.6

2.4

2.2

2.0

1.8

1.6

1.4

1.2

1.0

0.8

0.6

Relative

risk of

death


Stressful Life Events

� Chronic Stress by Age


Perceived Control

� Equality and Longevity

3


Stress

• Mental and physical condition that occurs when a person must adjust or adapt to the environment– Includes marital and financial problems

• Stress Reaction: Physical reaction to stress– Autonomic Nervous System is aroused

• Stressor: Condition or event that challenges or threatens the person

• Pressure: When a person must meet urgent external demands or expectations


Fig. 15.2. Stress is the product of an interchange between a person and the environment.


Burnout

• Burnout: Job-related condition (usually in

helping professions) of physical, mental,

and emotional exhaustion

– Emotional Exhaustion: Feel “used up” and

apathetic toward work

– Cynicism: Detachment from the job

– Feeling of reduced personal accomplishment


––Sources of Stress: DonSources of Stress: Don’’t Hassle t Hassle

Me?Me?

Stress and Health

What Are the Relationships Among Daily What Are the Relationships Among Daily

Hassles, Life Changes, and Physical Illness?Hassles, Life Changes, and Physical Illness?


Appraising Stressors

• Threat: Event or situation perceived as

potentially harmful

• 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


Perceived Control� Health consequences of a loss of control

No connection

to shock source

To shock control To shock source

“Executive” rat “Subordinate” rat Control rat

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Stress and the Heart

Hopelessness

scores

3.5

3

2.5

2

1.5

1

0.5

0Heart attack Death

Low risk Moderate risk High risk

Men who feel extreme hopelessness

are at greater risk for heart attacks

and early death


Stress and the Heart


Threats and Frustration

• Problem-Focused Coping: Managing or altering the distressing situation

• Emotion-Focused Coping: Trying to control one’s emotional reactions to the situation

• 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

• 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


Fig. 15.3 Frustration and

common reactions to it.

5


Defense Mechanisms (again)

• Denial

• Fantasy

• Intellectualization

• Undoing: Atonement, or ritual acts that “fix” the quilt ridden act.

• Overcompensation: overdoing a desirable characteristic (body building) or overdoing a non-desirable trait out of frustration (overeating for an obese person).


––Sources of Stress: DonSources of Stress: Don’’t Hassle t Hassle

Me?Me?

Models for ConflictModels for Conflict


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 becoming ill)

– NOT choosing may be impossible or undesirable


Conflicts (cont.)

• 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


Fig. 15.4 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. 15.5 Conflict diagrams. As shown by the colored areas in the graphs, desires to

approach and to avoid increase near a goal. The effects of these tendencies are depicted

below each graph. The “behavior” of the ball in each example illustrates the nature of the

conflict above it. An approach conflict (left) is easily decided. Moving toward one goal will

increase its attraction (graph) and will lead to a rapid resolution. (If the ball moves in either

direction, it will go all the way to one of the goals.) In an avoidance conflict (center),

tendencies to avoid are deadlocked, resulting in inaction. In an approach-avoidance conflict

(right), approach proceeds to the point where desires to approach and avoid cancel each

other. Again, these tendencies are depicted (below) by the action of the ball. (Graphs after

Miller, 1944.)

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Fig. 15.3 Frustration and

common reactions to it.


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


Anxiety

• Feelings of tension, uneasiness,

apprehension, worry, and vulnerability

– We are motivated to avoid experiencing

anxiety


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


Fig. 15.6 In the normal course of escape and avoidance learning, a light dims shortly before

the floor is electrified (a). Since the light does not yet have meaning for the dog, the dog

receives a shock (non-injurious, 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.


Depression

• State of feeling despondent 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

7


Exercise reduces

Depression

� Aerobic

Exercise

� sustained

exercise that

increases heart

and lung fitness

Depression

score

14

13

12

11

10

9

8

7

6

5

4

3Before treatment

evaluation

After treatment

evaluation

No-treatmentgroup

Aerobicexercisegroup

Relaxationtreatmentgroup


Coping

• Coping: 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

• Catastrophizing: “Making mountains out of molehills” - - Constantly


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): Minor but frequent

stresses


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


Gate Control

Theory of Pain

8


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


Fig. 15.7 In biofeedback training, bodily processes are monitored and processed

electronically. A signal is then routed back to the patient through headphones, signal lights,

or other means. This information helps the patient alter bodily activities not normally under

voluntary control.


Cardiac Personalities

• Type A Personality: Personality type with elevated risk of heart attack; 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 A’s; significantly less likely 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


Health Locus of Control1. If I take care of myself, I can avoid illness (Internal)

2. Whenever I get sick it is because of something I’ve done or not done

(Internal)

3. Good health is largely a matter of good fortune (External)

4. No matter what I do, if I am going to get sick I will get sick (External)

5. Most people do not realize the extent to which their illnesses are controlled by

accidental happenings (External)

6. I can only do what my doctor tells me to do (External)

7. There are so many strange disease around that you can never know how or

when you might pick one up (External)

8. When I feel ill, I know it’s because I have not been getting the proper exercise

or eating right (Internal)

9. People who never get sick are just plain lucky (External)

10.People’s ill-health results from their own carelessness (Internal)

11.I am directly responsible for my health (Internal)


Effects of

Stress: a

dual system

• a. activation of

the sympathetic

nervous system;

• b. the HPA Axis

9


• Elevated cortisol:

• is linked to increased levels of

depression, memory problems and

• is directly related to impairment of

immune system functioning;

• A suppressed immune system

leaves the body vulnerable to

disease.


The General Adaptation

Syndrome


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


Immunity (yeah just like the stupid

show “Survivor”?)

• 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 and Disease

� Conditioning of

immune

suppression at

the physiological

level

UCS

(drug)

UCR

(immune

suppression)

UCS

(drug)

UCR

(immune

suppression)

CS

(sweetened

water)

CS

(sweetened

water) CR

(immune

suppression)Table of Contents Exit

Stress Management

• Use of 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

10


Stress and HealthStress and HealthStress and Health

––Coronary Heart DiseaseCoronary Heart Disease

TheThe

JobJob--

Strain Strain

ModelModel



Stress and Disease

� Negative emotions and health-related

consequences

Unhealthy behaviors(smoking, drinking,

poor nutrition and sleep)

Persistent stressors

and negative

emotions

Release of stress

hormones

Heart

disease

Immune

suppression

Autonomic nervoussystem effects(headaches,hypertension)


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 negative self-statements

Table of Contents Exit Table of Contents Exit

Resources for Healthy Living

• 1. Health & exercise

• 2. Positive beliefs

• 3. Social skills

• 4. Social support

• 5. Material resources

• 6. Personal control

• Internal locus of control

• 7. Relaxation

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The Health Belief Model (HBM)

• An individual will take preventative health action if:

– They feel susceptible to disease through genetic

factors

– They believe an illness could have serious

consequences

– They think preventative action will be beneficial

– They believe the costs (such as pain) do not

outweigh the benefits of the health action


(HBM)


Theory of Planned Behaviour

• Health intentions are determined by:

– Personal attitudes towards a behaviour (e.g. I will

enjoy giving up smoking because I will save

money)

– Beliefs about what is an acceptable way to behave

– Beliefs about whether the behavioural goals can be

achieved


Theory of Planned Behaviour


Promoting Health

� Religious Attendance


Promoting Health

� The religion factor is multidimensional

Religious

involvement

Healthy

behaviors

(less smoking,

drinking)

Social support

(faith

communities,

marriage)

Positive

emotions

(less stress,

anxiety)

Better health

(less immune system

suppression, stress

hormones, and suicide)

12


Meditation

• Mental exercise designed to focus attention and interrupt flow of thoughts, worries, and analyses

• Concentrative Meditation: Attention is paid to a single focal point (i.e., object, thought, etc.)– Produces relaxation response and thus works to reduce stress

• Receptive Meditation: Based on widening attention span to become aware of everything experienced at a given moment


Meditation (cont.)

• Mantra: Word(s) or sound(s) repeated

silently during concentrative meditation

• Relaxation Response: Occurs at time of

relaxation; innate physiological response

that opposes fight or flight responses

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