Introduction to Psychology

Stress, Coping, and Health

Health Psychology

• APA (1979) Health Psychology is the educational, research, and clinical contributions of Psychology to:

• The promotion and maintenance of health• The prevention and treatment of illness• The analysis and improvement of the health care

system and health policy formation.

50% of all deaths are preventable - due to lifestyles

Stress• A state that impairs our ability to respond to

internal and external demands– Stress is a psychobiological process– Stress is a stimulus e.g., catastrophies, life events,

circumstances– Stress is a response (physiological and

psychological)– Stress is a process (relationship between person

and environment)

Modern Views of Stress• Richard Lazarus: stress is a transaction between a

person and their environment– Primary appraisal: person evaluates situations as benign or

stressful

– Secondary appraisal: person decides how to deal with stress

• Lazarus identifies three types of stress:– Loss: person loses a loved one or a possession

– Threat: anticipated harm

– Challenge: opportunity for growth (new job)

© 2002 John Wiley & Sons, Inc.

Appraisal of Stress

• We can influence the impact of a stressor

a) Behaviorally e.g., drug use vs. relaxation

b) Cognitively e.g., denial vs. cognitive restructuring

c) Emotionally e.g., hopelessness vs. optimism

Physical Responses to Stress

General Adaptation Syndrome

• Alarm

• Resistance

• Exhaustion

- Reactivity, anxiety on a continuum

Sympathetic Adrenal Medullary system (SAM)

• Stress is perceived by cerebral cortex• Affects hypothalamus which activates the

sympathetic nervous system (fight or flight)• Stimulates the Adrenal Medulla glands which

secrete catecholimines, epinephrine, and norepinephrine

• Raises blood pressure, irregular heart rate, sweating, constriction of peripheral blood vessels

Hypothalmic-Pituitary-Adrenocorticol system (HPA)

• Hypothalamus releases corticotrophin releasing factor (CRF)

• Influences Pituitary gland to secrete adrenocorticotropic hormone (ACTH)

• This affects adrnal cortex, relasing coritcosteroids like cortisol that reduce inflammation and help body return to normal state after acute stressors

Physical Symptoms of Stress

• 1) increases in heart rate and pressure2) increased adrenaline and noradrenaline3) stomach ulcers4) injuries5) fatigue6) death 7) heart disease

• 8) lung diseases9) increased sweating10)  skin rashes11)  headaches12)  cancer 13)  muscular tension14)  sleep disorders

Prolonged Exposure to Stress

• Suppress cellular immune functioning• Produces hemodynamic changes (increased heart

rate and blood pressure)• Provoke irregular heart rhythms• Produce neurochemical imbalances (depression,

panic disorder)• Atherosclerosis• Destruction of neurons in the hippocampus

(memory impairment, senility)

Psychological Responses to Stress

• Emotional instability

• Thinking problems:

- problem solving difficulties

- Ruminative thinking

- Castastrophizing

- Irrational thoughts

Psychological Symptoms of Stress

• 1) anxiety, tension, confusion, & irritability2) frustration, anger, and resentment3) hypersensitivity, hyperactivity4) suppression of feelings5) poor communication6) withdrawal and depression

• 7) feeling isolated and alienated8) boredom, job dissatisfaction9) mental fatigue, poor reasoning10)  poor concentration11) loss of spontaneity & creativity12) lowered self-esteem

Behavioral Responses to Stress

• 1) procrastination & avoidance2) lowered performance3) increased alcohol & drug use and abuse4) intentional acts of sabotage5) increased use of prescription drugs6) undereating due to apathy, depression

• 7) overeating as an escape8) weight loss9) increased recklessness, gambling10)  aggression and criminal acts11)  poor relations with family and friends12)  suicide or attempted suicide

Coping

Coping is the process by which people try to manage the perceived discrepancy between the demands and resources they appraise in a stressful situation

Recognize the importance of individualistic coping mechanisms and the role of belief and expectationin determining the outcome of a stressful eventwhere impact depends on how event is appraised

- problem and emotion focused coping

Emotion Focused Coping

• Emotion focused coping is aimed at controlling the emotional response to the stressful situation

Behavioral – drugs, distraction, or support

Cognitive – denial, optimism, hardy personality

Problem Focused Coping

• Problem focused coping is aimed at reducing the demands of the stressful situation or expanding the resources available to deal with the stressor

• E.g., quit job, seek treatment or support, learn new skill to adapt to situation

Person attempts to change the situation– Try to remove the stressor– Plan ways of resolving the situation– Seek advice from others on how to change the situation

Social Support and Stress• Other persons can provide social support:

– Two-way communication in which a person can confide their concerns and receive support from others

• Low social support decreases life span• Social support may work by

– Buffering person against the harmful effects of stress

– Social support is a positive force that reduces susceptibility to stress

Positive Coping Strategies

• Focused breathing/meditation• Progressive Muscle relaxation• Cognitive restructuring• Visualization and Imagery • Self hypnosis• Anger management• Thought Stopping Procedures• Stress Inoculation Training• Assertiveness Training/Social Skills Training• Time Management

Affirmations (Benson, 1995)• I can handle this

I accept myself as I amI am peacefulI am becoming healthy and strongLet it beI am doing the best that I can

through repetition and imagination you can speak directly to your own unconscious mind (which takes everything you say as truth and creates your belief system about they way the world works)

effective affirmations are1) stated in the positive2) written down on paper3) posted everywhere for repeated viewing

Health and Well Being• Benson & Friedman (1995)

The Three Legs supporting health & wellbeing- pharmaceuticals- surgery and medical procedures- self-care (the leg that has been missing) of the inner development of the whole person and nurturing beliefs that faciltate healing- Western Thinking needs an overhaulMany medical experts like Benson are recognizingwe need to borrow from the older eastern traditions.(Deepak Chopra, Andrew Weil, Jon Kabat-Zinn)