Chapter 11 Health, Stress, and Coping

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Chapter 11Health Stress and Coping
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Health Psychology and Behavioral Risk Factors

• Health Psychology Uses behavioral principles to
  prevent illness and promote health
• Behavioral Medicine Applies psychology to manage
  behavioral problems
• Lifestyle Diseases Diseases related to
  health-damaging personal habits
• 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 and hostile

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Figure 11.1
FIGURE 11.1 The nine leading causes of death in
the United States are shown in this graph. As you
can see eight of the top nine causes are
directly related to behavioral risk factors
(infection is the exception). At least 45 percent
of all deaths can be traced to unhealthful
behavior. The percentage of day-to-day health
problems related to unhealthful behavior is even
higher.
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Ways to Promote Health

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

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Table 11.2
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Stress

• Mental and physical condition that occurs when a
  person must adjust or adapt to the environment
• Includes marital and financial problems
• Eustress Good stress (e.g. travel dating)
• Stress Reaction Physical response 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

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Burnout

• Burnout Job-related condition (usually in
  helping professions) of physical mental and
  emotional exhaustion. Has three aspects
• Emotional Exhaustion Feel used up and empty
• Cynicism or detachment from others
• Feeling of reduced personal accomplishment

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Appraising Stressors

• Primary Appraisal Deciding if a situation is
  relevant or irrelevant positive or threatening
• Secondary Appraisal Deciding how to cope with a
  threat or challenge
• Perceived lack of control is just as threatening
  as an actual lack of control

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Figure 11.2
FIGURE 11.2 Stress is the product of an
interchange between a person and the environment.
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Threats and Frustration

• Problem-Focused Coping Managing or altering the
  distressing situation
• Emotion-Coping Focusing Trying to control ones
  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

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Figure 11.3
FIGURE 11.3 Frustration and common reactions to
it.
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Reactions to Frustration

• Aggression Any response made with the intention
  of doing harm
• Displaced Aggression Redirecting aggression to a
  target other than the source of ones frustration
• Scapegoating Blaming a person or group for
  conditions they did not create the scapegoat is
  a habitual target of displaced aggression
• Escape May mean actually leaving a source of
  frustration (dropping out of school) or
  psychologically escaping (apathy)

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Conflicts

• A stressful condition that occurs when a person
  must choose between contradictory needs desires
  motives or demands
• Avoidance-Avoidance Conflicts Being forced to
  choose between two negative or undesirable
  alternatives (e.g. choosing between going to the
  doctor or contracting cancer)
• NOT choosing may be impossible or undesirable
• 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

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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

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Figure 11.5
FIGURE 11.5 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.
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Anxiety

• Feelings of tension uneasiness apprehension
  worry and vulnerability
• We are motivated to avoid experiencing anxiety

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Freudian Defense Mechanisms Psychological
Defenders of You!

• Defense Mechanisms Habitual and unconscious (in
  most cases) psychological processes designed to
  reduce anxiety
• Work by avoiding denying or distorting sources
  of threat or anxiety
• If used short term can help us get through
  everyday situations
• If used long term we may end up not living in
  reality
• Protect idealized self-image so we can live with
  ourselves

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Freudian Defense Mechanisms Some Examples

• Denial Most primitive denying reality usually
  occurs with death and illness
• Repression When painful memories anxieties and
  so on are held out of our awareness
• Projection When ones own feelings
  shortcomings or unacceptable traits and impulses
  are seen in others exaggerating negative traits
  in others lowers anxiety
• Rationalization Justifying personal actions by
  giving rational but false reasons for them
• Reaction Formation Impulses are repressed and
  the opposite behavior is exaggerated

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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

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Figure 11.6
FIGURE 11.6 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.
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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
• Mastery Training Responses are reinforced that
  lead to mastery of a threat or control over ones
  environment
• One method to combat learned helplessness and
  depression

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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 cant handle your responsibilities and feel
  overwhelmed.

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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
• Life Change Units (LCUs) Numerical values
  assigned to each life event on the SRRS

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Psychosomatic Disorders

• 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

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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

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Figure 11.7
FIGURE 11.7 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.
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Cardiac Personalities

• Type A Personality Personality type with
  elevated risk of heart attack characterized by
  time urgency and chronic anger or hostility
• Anger and hostility may be the key factors of
  this behavior
• Type B Personality All types other than Type As
  unlikely to have a heart attack

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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

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General Adaptation Syndrome (GAS)

• Series of bodily reactions to prolonged stress
  occurs in three stages

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Alarm Reaction

• Alarm Reaction Body resources are mobilized to
  cope with added stress

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Stage of Resistance

• Stage of Resistance Body adjusts to stress but
  at a high physical cost resistance to other
  stressors is lowered

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Stage of Exhaustion

• Stage of Exhaustion Bodys resources are drained
  and stress hormones are depleted possibly
  resulting in
• Psychosomatic disease
• Loss of health
• Complete collapse

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Immunity (Similar to 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

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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

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Stress Management (contd)

• 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

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Figure 11.9
FIGURE 11.9 The Stress Game. (Adapted from
Rosenthal and Rosenthal 1980.)
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Sexually Transmitted Disease (STD)

• A disease that is passed from one person to
  another by intimate physical contact a venereal
  disease
• Asymptomatic Having a disease while lacking
  obvious symptoms
• Makes the disease harder to detect
• Human Immunodeficiency Virus (HIV) Sexually
  transmitted virus that disables the immune system

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Acquired Immune Deficiency Syndrome (AIDS)

• Acquired Immune Deficiency Syndrome (AIDS)
  Caused by HIV and frequently fatal the immune
  system is weakened allowing other diseases and
  infections to invade the body
• White Blood Cell (WBC) count is often lowered
  dangerously

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STD Risky Behaviors

• Sharing drug needles and syringes
• Anal sex with or without a condom
• Unprotected sex (without a condom) with an
  infected partner
• Sex with someone you know who has several
  partners
• Vaginal or oral sex with an intravenous drug user
• Having many sex partners

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Safer Sex Practices

• Not having sex
• Not injecting drugs
• Using a condom
• Sex with one mutually faithful uninfected
  partner
• Not engaging in sex while intoxicated
• Reducing the number of sex partners