DrMarshallpsychch13ppt

1. Lecture Slides
Chapter Thirteen
Stress,
Health, and
Coping
By Glenn Meyer
Trinity University

2. Introduction: Stress and
Health Psychology
Cognitive Appraisal
Model
• Developed by
Richard Lazarus
• Whether we
experience stress
depends largely on
cognitive appraisal of
an event and the
resources we
possess to deal with
event
Stress
Negative emotional state
occurring in response to
events that are
perceived as taxing or
exceeding a person’s
resources or ability to
cope

5. How to
promote
health-enhancing
behaviors
Main foci
How people
respond to
being ill
Health
Psychology
Studies how
biological,
behavioral, and
social factors
influence health,
illness, medical
treatment, and
health-related
behaviors
How people
respond in the
patient–health
practitioner
relationship

6. Sources of Stress
Life Events and Change
• Stressors—events that are
perceived as harmful, threatening,
or challenging
• Early stress researchers (Holmes
and Rahe, 1967) believed any
change that required you to adjust
your behavior and lifestyle would
cause stress
• Developed the Social
Readjustment Rating Scale
(SRRS)

7. Problems with the SRRS
• Link between SRRS and physical
and psychological problems is
weak
• Assumes that a given life event
will have the same impact on
everyone
• Assumes that change in itself,
whether good or bad, produces
stress
• Most researchers agree that
undesirable events are significant
sources of stress but that change
in itself is not necessarily stressful

8. Traumatic Events
Events or situations that are
negative, severe, and far
beyond our normal
expectations for everyday life
or life events
• 85% of people report having been exposed to a traumatic
event during their lifetime
• When traumas are intense or repeated, some
psychologically vulnerable people may develop post-traumatic
stress disorder (abbreviated PTSD).
• Fewer than 30% of those who experience major
disasters—such as floods, earthquakes, and hurricanes—
develop PTSD

9. Developing
Resilience
• Seery - high and low levels
of cumulative adversity were
associated with poor health
outcomes
• Experiencing some stress
was healthier than
experiencing no stress at all
• People who have had to
cope with a moderate level
of adversity develop
resilience
• Ability to cope with stress
and adversity, to adapt to
negative or unforeseen
circumstances, and to
rebound after negative
experiences

10. Daily Hassles
That’s Not What I Ordered!
• Everyday minor events that annoy
and upset people
• Such ordinary irritations in daily life
might be an important source of
stress
• Number of daily hassles people
experience is a better predictor of
physical illness and symptoms than
is the number of major life events
experienced
• Women are more likely to report
daily stressors that are associated
with friends and family
• Men are more likely to feel hassled
by stressors that are school-related
or work-related

11. People feel
exhausted, as if
they’ve used up all
of their emotional
and physical
resources
People experience
feelings of cynicism,
demonstrating
negative or overly
detached attitudes
People feel a sense
of failure or
inadequacy, have a
sharply reduced
sense of
accomplishment or
productivity
Work Stress and Burnout
Is It Quitting Time Yet?
Burnout
an unhealthy
condition caused by
chronic, prolonged
work stress that is
characterized by
exhaustion,
cynicism, and a
sense of failure or
inadequacy
Three Sources
Click here
Causes
overload
lack of control
Solution
sense of community

12. Social and Cultural Sources of Stress
• People who live under difficult
or unpleasant conditions
experience chronic stress.
• Crowding, crime, poverty,
and substandard housing
• People in less privileged
groups have fewer resources
with which to cope with
stressors
• Chronic stress is also
associated with lower
socioeconomic status
• Perceiving yourself as being of
low social status is associated
poorer physical health
• Racism and discrimination are
another important source of
chronic stress
• Subtle instances of
racism, called
microaggressions,
contribute to chronic
stress

13. The Stress of Adapting
to a New Culture
Reducing stress
• Acculturative stress is
reduced when new
society accepts ethnic
and cultural diversity
• Transition is eased when
person has some
familiarity with new
language and customs,
advanced education, and
social support from
friends, family members,
and cultural associations
• Acculturative stress is
lessened if the new
culture is similar to old
culture
Acculturative stress
Stress that results from the
pressure of adapting to a new
culture

14. The Stress of Adapting
to a New Culture
Two questions are faced
when entering a new
culture:
1. Should I seek positive
relations with the
dominant society?
2. Is my original cultural
identity of value to me,
and should I try to
maintain it?
Integration
low stress
Four
possible
patterns of
acculturatio
n
Assimilation
moderate stress
Separation
high stress
Marginalization
greatest stress

15. Physical Effects of Stress
The Mind–Body Connection
Stress can
indirectly affect
a person’s health
by prompting
behaviors that
jeopardize
physical
well-being, such
as not eating or
sleeping properly
Stress can
directly affect
physical health
by altering body
functions, leading
to symptoms of
illness or disease

16. Stress, Fight or Flight, and the
Endocrine System — Walter Cannon
Endocrine response
Click here
Fight-or-flight response
Click here
• Rapidly occurring chain
of internal physical
reactions that prepare
people either to fight or
take flight from an
immediate threat
• First described by Walter
Cannon
• Threat perceived (amygdala),
hypothalamus and lower brain
structures activate sympathetic
nervous system
• Sympathetic nervous system
stimulates adrenal medulla to
secrete hormones called
catecholamines, including
adrenaline and noradrenaline
• Catecholamines trigger rapid
and intense bodily changes
associated with the fight-or-flight
response
• Cannon believed prolonged
arousal is harmful

19. Hans Selye and General Adaptation
Syndrome
Prolonged Stress
• Stress causes
pituitary to release
ACTH
• ACTH causes
adrenals to release
corticosteroid
(cortisol)
• Short-term reduce
inflammation,
enhance muscles
• Long-term weaken
immune system
Hans Selye – Effects of
Exposure to Extreme
Stress in Rats
• Adrenal glands became
enlarged
• Stomach ulcers and loss
of weight occurred
• Shrinkage of the thymus
gland and lymph glands,
two key components of the
immune system

20. Prolonged Stress Produces General
Adaptation Syndrome (GAS)
Alarm
• Intense arousal
• Mobilization of physical
resources (release of
catecholamines)
• Arousal remains above
normal
Resistance
• Body actively
tries to resist
or adjust to
the continuing
stressful
Exhaustion
• This leads to physical exhaustion
and physical disorders
• Symptoms of the alarm stage
reappear, only now irreversibly
• Energy reserves depleted and
adaptation begins to break down,
leading to death
GAS
A three-stage progression of physical
changes that occurs when an organism is
exposed to intense and prolonged stress
Click here to see stages

22. Stress, Chromosomes, and Aging
The Telomere Story
Telomeres
Repeated duplicate
DNA sequences that
are found at the
very tips of
chromosomes
• Telomeres protect genetic data in the chromosomes
from being broken or scrambled during cell division
• With each cell division, the string of telomeres gets
shorter
• Shorter telomeres linked with aging, age-related
diseases, and mortality
• Elevated levels of the stress hormones cortisol and the
catecholamines linked to shorter telomeres
• People under chronic stress have shortened telomeres

23. Perceived Stress and Telomere Length In
a groundbreaking study, psychologist Elissa
Epel and her colleagues (2004) compared
telomere length in mothers of chronically ill
children with mothers of healthy children.
Even after controlling for age and other
biological factors, telomeres were
significantly shorter in women who
perceived themselves as being under a
great deal of stress than in those who did
not. The reduction in telomere length in the
highly stressed women was roughly
equivalent to more than a decade of normal
aging (Epel & others, 2004).
Effects of Chronic and Acute Stress
on Telomerase Activity
Telomerase is an enzyme that protects
and lengthens telomeres. In an
experiment by Elissa Epel and her
colleagues (2010), telomerase activity
was significantly lower in women who
were under chronic stress
(“caregivers”) than it was in a control
group of women who were not under
stress.

24. Stress and the
Immune System
Important Terms
system that produces
specialized white blood
cells that protect body
from viruses, bacteria,
and tumor cells
Immune system
specialized white
blood cells that fight
bacteria, viruses,
and other foreign
invaders
Lymphocytes
An interdisciplinary field
that studies the
interconnections among
psychological processes,
nervous system, and
immune system
Psychoneuroimmunology

25. An interdisciplinary field
that studies the
interconnections among
psychological processes,
nervous system, and
immune system
Psychoneuroimmunology
• Central nervous system and the
immune system are directly linked
via sympathetic nervous system
• Surfaces of lymphocytes contain
receptor sites for neurotransmitters
and hormones, including
catecholamines and cortisol
• Psychoneuroimmunologists have
discovered that lymphocytes
themselves produce
neurotransmitters and hormones

26. Stressors that Can Influence the
Immune System
• Highly stressful events associated with reduced immune
system functioning
• Common stresses can impair immune system
• End or disruption of important interpersonal
relationships
• Caring for a family member with Alzheimer’s disease
• Marital arguments
• Pressure of exams can adversely affect the immune
system

27. The Mysterious
Placebo Effect
Placebo
inactive substance with no known effects
• Genuine painkilling drugs and
placebos activate the same brain
area, called the anterior cingulate
cortex
• Anterior cingulate cortex contains
many opioid receptors
• Placebo treatment activates opioid
receptors in several brain regions
associated with pain
• Cognitive expectations, learned
associations, and emotional
responses can have a profound
effect on perception of pain

28. Individual Factors that Influence the
Response to Stress
Psychological Factors—Personal Control
• People who can control a stress-producing event often
show no more psychological distress or physical arousal
than people who are not exposed to the stressor at all
• Rodin and Ellen Langer (1977):
• Nursing-home residents who had opportunities to make
choices (high control) were more active, alert, and
healthier than does who did not (low control)
• Twice as many low-control residents passed away
• Perception of personal control must be realistic to be
adaptive
• Personal control is more valued in individualistic cultures

29. Explanatory Style
Seligman
Optimistic
Explanatory Style
Use external,
unstable, and
specific explanations
for negative events
Predicts better health
outcomes – strong
immune system
Pessimistic
Explanatory Style
Use internal, stable,
and global
explanations for
negative events
Predicts worse health
outcomes
Explanatory style is relatively stable,
especially for negative events

30. Positive Emotions
Click here
Chronic Negative Emotions
Click here
• Strong link between
negative emotions and
poor health
• People who are habitually
anxious, depressed, angry,
or hostile are more likely to
develop a chronic disease,
such as arthritis or heart
disease
• Associated with increased
resistance to infection,
decreased illnesses, fewer
reports of illness symptoms, less
pain, and increased longevity
• Less likely to develop heart
disease
• Bring calming and health
protective effects to the
cardiovascular, endocrine, and
immune systems
• Associated with health-promoting
behaviors
• Predict more friends and
stronger social networks

31. Type A Behavior and Hostility
Exaggerated sense of time
urgency, trying to do more and
more in less time
• General sense of hostility,
displaying anger and irritation
• Intense ambition and
competitiveness
• Hostility component associated
with heart disease
• Hostile Type As react more
intensely to a stressor than
other people do
• Experience greater increases in
blood pressure and heart rate
Type B
• More easygoing, relaxed, laid
back
• Not associated with heart
disease

32. Do Personality Factors Cause Disease?
• Psychologists and other scientists are cautious about the
connections between personality and health
• Many studies are correlational
• Personality factors might indirectly lead to disease via poor
health habits
• Disease may influence a person’s emotions, rather than
the other way around
• Researchers try to disentangle the relationship by
prospective studies

33. Social Factors
A Little Help from Your Friends
Effects of low social support
• Socially isolated people were twice as likely to die as people with good
Negative interactions with
other people are often
more effective at creating
psychological distress than
positive interactions are at
social relationships
• Chronic loneliness predicts poorer physical and mental health, higher
death rates, and decreased cognitive functioning
• More likely have serious health problems if parents are low in love and
caring
• Isolation is as potent a health risk as smoking, obesity, alcohol abuse, and
However…
physical inactivity
Social support
Resources provided by other
people in times of need
Positive Effect of Diverse Social Networks
• Greater resistance to upper respiratory infections
• Lower incidence of stroke and cardiovascular disease among women in a
improving well being
high-risk group
• Lower incidence of dementia and cognitive loss in old age (Desai & others,
2010)
How Social Support Benefits Health
• Can modify our appraisal of a stressor’s significance
• Seems to decrease the intensity of physical reactions to a stressor
• Making us less likely to experience negative emotion
• Direct assistance – money, meals, trips to doctor, referrals

34. Gender Differences in the Effects of
Social Support
• Men rely on close relationship
with spouse or partner
• Women list close friends
along with their spouse as
confidant
• Men are particularly
vulnerable to social isolation
Risks for Women:
• Women serve as
providers of support,
which can be
stressful
• Women suffer from
the stress contagion
effect
• Women become
more upset about
negative events that
happen to relatives
and friends

35. Providing
Effective
Social Support
Effective Strategies
Emotional Support
expressions of
concern, empathy,
and positive regard
Be a good listener and show
concern
Ask questions that encourage
the person under stress to
express feelings and emotions
Express understanding about
why the person is upset
Express affection for the person
Be willing to invest time and
attention in helping
Help person with practical tasks
Tangible
Support
involves direct
assistance
Unhelpful Strategies
Giving advice that the person
under stress has not requested
Saying “I know exactly how you
feel”
Talking about yourself or your
own problems
Minimizing the importance of
the person’s problem
Joking or acting overly cheerful
Offering your philosophical or
religious interpretation

36. Coping: How People
Deal with Stress
Coping
Behavioral and cognitive responses used to deal with stressors;
involves efforts to change circumstances, or our interpretation of
them to make them more favorable and less threatening
Adaptive coping
• Dynamic and complex process
• Involves realistically evaluating situation and
determining what can be done to minimize the
impact of the stressor
• Adaptive coping also involves dealing with the
emotional aspects of the situation

37. Confrontive coping
Uses aggressive or
risky tactics
Ideal if direct and
assertive but not
hostile
Problem-
Focused
Coping
Strategies
Click here
Planful problem
solving
Rationally analyze
situation
Identify solutions
Implement solutions
Problem-focused
coping
Aimed at managing or
changing the stressor
Most effective when
you can exercise
control

38. Gender Differences in
Responding to Stress
“Tend-and-Befriend” or “Fight-or-Flight”?
• Men tend to withdraw
from their families,
wanting to be left alone
• Women tend to seek
out interactions with
their marital partners
• Women likely to seek
out and use social
support when under
stress
Why?
• Tending to offspring in
times of stress would be
vital to ensuring survival of
species
• Women developed a tend-and-
befriend behavioral
response to stress rather
than fight-or-flight
• Maybe because oxytocin is
higher in women than in
men
• Oxytocin associated with
maternal behaviors

39. Emotion-Focused
Coping Strategies
Coping efforts primarily aimed at
relieving or regulating the emotional
impact of a stressful situation.
Used when people think that nothing can be done to alter a situation
Escape-avoidance: Try to escape stressor
• Examples: sleeping, drugs, fantasy, exercising, immersing self in work,
hobbies, studies
• Associated with poor adjustment, depression, anxiety
Seeking social support
Distancing: Minimize impact of stressor
• Humor
• Detached, intellectual, or depersonalized attitude
Denial: Refuse to acknowledge problem
• Can compound the situation
Positive Reappraisal
• Positive religious coping
• Associated with lower stress, better health
Negative Religious Coping
• Anger, question beliefs, think they are being punished
• Can lead to poor health

40. Culture and Coping Strategies
Collectivistic Cultures
Click here
Individualistic Cultures
Click here
• Emphasizes personal autonomy
and personal responsibility in
dealing with problems
• Emphasize importance and
value of exerting control over
circumstances
• Less likely to seek social
support in stressful situations
than are members of
collectivistic cultures
• Favor problem-focused
strategies, such as confrontive
coping and planful problem
solving
• Oriented toward social
group, family, or
community, and toward
seeking help with
problems
• Greater emphasis is
placed on controlling your
personal reactions
• More likely to rely on
emotional coping
strategies than people in
individualistic cultures

41. B. F. Skinner
and the
Search for
“Order in
Behavior”
Minimizing the Effects of Stress
Suggestion 1
Avoid or minimize the use of stimulants.
Suggestion 2
Exercise regularly.
Suggestion 3
Get enough sleep.
Suggestion 4
Practice a relaxation technique.