Stress, Coping, and Health

The RelationshipBetween Stress and Disease

• Contagious diseases vs. chronic diseases – Biopsychosocial model– Health psychology

• Health promotion and maintenance

– Discovery of causation, prevention, and treatment

Stress: An Everyday Event

• Major stressors vs. routine hassles– Cumulative nature of stress– Cognitive appraisals

Major Types of Stress

• Frustration: blocked goal• Conflict: incompatible

motivations– Approach-approach– Approach-avoidance– Avoidance-avoidance

• Change: having to adapt– Social Readjustment

Rating Scale– Life Change Units

• Pressure– Perform/conform

Overview of the Stress Process

Responding to Stress Emotionally

• Emotional Responses– Annoyance, anger, rage– Apprehension, anxiety,

fear– Dejection, sadness, grief– Positive emotions

• Emotional response and performance– The inverted-U-

hypothesis

Responding to Stress Physiologically

• Physiological Responses– Fight-or-flight response– Selye’s General Adaptation Syndrome

• Alarm • Resistance• Exhaustion

Responding to Stress Behaviorally

• Behavioral Responses– Frustration-aggression

hypothesis– catharsis– defense mechanisms

• Coping– Reappraisal– Confronting problems– Using humor– Expressing emotions– Managing hostility

Effects of Stress:Behavioral and Psychological

• Impaired task performance

• Burnout• Psychological

problems and disorders

• Positive effects

Effects of Stress: Physical

• Psychosomatic diseases• Heart disease

– Type A behavior - 3 elements

• strong competitiveness• impatience and time

urgency• anger and hostility

– Emotional reactions and depression

• Stress and immune functioning– Reduced immune activity

Factors Moderating the Impact of Stress

• Social support– Increased immune functioning

• Optimism– More adaptive coping– Pessimistic explanatory style

• Conscientiousness– Fostering better health habits

• Autonomic reactivity– Cardiovascular reactivity to stress

Firefighter Specific Stressors

• Reliance on teamwork• Low job control• Sleep disturbances/Shift work• Boredom• Coworker conflict• Management-Labor conflict• Second jobs• Marital/Family spillover

Firefighter Stress Reactions

• Apprehension/Dread

• Intrusive thoughts

• No hope

• Sleep difficulties

• Gastrointestinal symptoms

• Throat and mouth symptoms

At-Risk Firefighters

• Research reveals 2 distinct profiles for at-risk firefighters– Profile 1 (somaticizers) Reported greater frequency

and intensity of physical symptoms• Head/neck/facial tension• Gastrointestinal distress• Cardiopulmonary complaints

– Profile 2 (psychological stress) Reported higher levels of

• Apprehension/dread• Anger• Generalized anxiety• Agitated depression

Implications for treatment

• Identify high-risk firefighters– No penalty or stigmatization

• Potential interventions– Psychoeducation

• Work redesign• Coping skills training• Relaxation training• Conflict-resolution training• Leadership training• Sleep hygiene education

Coping Skills

• Problem-focused coping– Taking direct action

– Planning

– Suppression of competing activities

– Restraint coping

– Seeking social support

• Emotion-focused coping– Focusing on and venting

emotions

– Behavioral disengagement

– Mental disengagement

– Positive reappraisal

– Denial

– Acceptance

– Turning to religion