Chapter 18 Stress, Coping, Health

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4 22 08

• Chapter 18 Stress, Coping, Health
• 1. Some material from chapter
• 2. Tomaka stress, appraisal, health
• 3. Scheier optimism health
• 4. Pennebaker biases in symptom reports

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Chapter 18 Stress, Coping, Health

• HIV rates in Africa
• Botswana
• Swaziland
• Zimbabwe

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Chapter 18 Stress, Coping, Health

• Although proximate cause of HIV is a virus
• Unsafe sex
• Sharing needles
• Which deals with behavior

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Chapter 18 Stress, Coping, Health

• Role for personality
• As infection/death (e.g., smallpox) pretty much
  eliminated as a cause of death
• Smoking
• Diet
• Exercise
• Stress
• Accounting for

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Chapter 18 Stress, Coping, Health

• Health Psychology
• How personality factors predict reactions to
• Stress
• Illness

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Chapter 18 Stress, Coping, Health

• Cohen et al (1997) study
• Some ss had experienced a lot of stress in year
• If more stress,
• Conclusions
• Stress
• Stress leads to more illness

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Chapter 18 Stress, Coping, Health

• Managing emotions
• Gross, Levenson studies
• Suppression
• Body
• Face
• Subjective
• King Emmons (1990)
• Emotional expressiveness is healthy
• Those who

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Chapter 18 Stress, Coping, Health

• Pennebaker cost of inhibiting traumatic memories
• Headaches
• Trouble sleeping
• Lower immune functioning
• Illness
• Pennebaker (1990)
• 1 hour (4 days x 15 minutes) of writing about
  trauma
• Less

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Chapter 18 Stress, Coping, Health

• But all emotion control is not bad
• Among children
• Ability to control neg affect greatly beneficial
• Among adults
• Reappraisal
• This is associated with higher SWB, many positive
  benefits
• Conclusions

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Chapter 18 Stress, Coping, Health

• Type A and cardiovascular disease
• One of most important causes of death in USA
• Competitive
• Aggressive
• Active, energetic
• Ambitious, driven
• Thus,

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Chapter 18 Stress, Coping, Health

• What about Type A is lethal?
• Hostility
• Easily frustrated, even by little things
• Irked, peaved, upset, etc.
• But not necessarily overtly aggressive

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Chapter 18 Stress, Coping, Health

• How Type A affects cardiovascular functioning
• Higher heart rate
• Result is blood pressure
• Causes wear and tear on arteries
• Fat molecules glob into these tears
• Arteries harden and become narrow
• Again because of fat build up

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Threat, Challenge, Appraisal, Body (Tomaka et
al., 1997)

• Stress
• Ones capacities exceeded by demands of situation
• Feeling is anxiety, being overwhelmed, doubtful

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Threat, Challenge, Appraisal, Body (Tomaka et
al., 1997)

• Stress and appraisal
• Appraisal
• Primary appraisal
• Threatening or not
• No stress if not seen as threatening
• Secondary appraisal
• Presumably ability state of mind
• Less stress if answer is yes

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Threat, Challenge, Appraisal, Body (Tomaka et
al., 1997)

• Stress and appraisal
• Threat exceeding resources
• Or primary exceeding secondary
• Ratio
• Higher means more perceived threat

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Threat, Challenge, Appraisal, Body (Tomaka et
al., 1997)

• Stress and appraisal
• Tomaka ratio measure

low
high
low
high
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Threat, Challenge, Appraisal, Body (Tomaka et
al., 1997)

• Study 1
• What is 14 x 15?
• What is 89 - 13?
• What is 52 / 4?
• Etc.
• Quite fast

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Threat, Challenge, Appraisal, Body (Tomaka et
al., 1997)

• Study 1
• you must perform quickly
  and accurately we will assess this
• do the best you can
  view situation as a challenge you can meet
• Altered

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Threat, Challenge, Appraisal, Body (Tomaka et
al., 1997)

• Cardiovascular Profiles
• More
• Higher blood flow, HR
• Prepared to meet situation
• Less
• Less tightening of arteries, capillaries
• Would create blood pressure
• More trying to get through less space

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Threat, Challenge, Appraisal, Body (Tomaka et
al., 1997)

• Conclusions
• 1.
• When situation perceived as threatening (
  )
• And doubts concerning coping abilities (
  )
• 2. Differences in being challenged versus
  threatened
• high cardiac output low
  vascular resistance
• lower cardiac output higher
  vascular resistance
• The is much worse for
  cardiovascular health

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Optimism and Recovery from Surgery (Scheier et
al., 1989)

• Can positive thinking overcome medical adversity?
• Dont worry be happy
• Humor guy
• Somewhat skeptical
• However, could there be truth to this idea?

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Optimism and Recovery from Surgery (Scheier et
al., 1989)

• Scheier Carver (1985)
• General optimism
• Time 1 symptom reports
• Then finals week
• Then time 2 symptom reports
• Optimism predicted
• Health benefits of

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Optimism and Recovery from Surgery (Scheier et
al., 1989)

• Coping strategies during stress
• Optimists
• 
  (e.g., made a plan of action)
• Pessimists
• 
  (e.g., I try to convince myself my anxiety is
  unwarranted)
• 
  (e.g., I tell myself things really arent that
  bad (when they are))

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Optimism and Recovery from Surgery (Scheier et
al., 1989)

• Present study
• Patients undergoing
• 170,000 operations every year in USA
• Not much effect on longevity (?)
• Less heart angina, higher satisfaction
  post-operatively

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Optimism and Recovery from Surgery (Scheier et
al., 1989)

• Sample
• 51 patients
• Mean age 49
• All men
• 50 blockage
• 31 one blocked vessel
• 47 two blocked vessels
• 18 three blocked vessels

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Optimism and Recovery from Surgery (Scheier et
al., 1989)

• Optimism
• 
  (internal, stable, global explanations for good
  events)
• Rather of
  good or bad things happening in future
• I look on the bright side of life
• I hardly ever expect things to go my way
• Im always optimistic about the future

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Optimism and Recovery from Surgery (Scheier et
al., 1989)

• Initial contact
• Pre-surgery optimism, mood
• 6-8 days post-surgery
• Symptoms of fatigue, pain, morale
• 6 months post-surgery
• How long it took to resume normal activities
  (work, exercise, sex, socializing)
• Life satisfaction

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Optimism and Recovery from Surgery (Scheier et
al., 1989)

• Results
• Optimism and
• of blockages
• Clamp time
• Thus, equally serious surgical procedures

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Optimism and Recovery from Surgery (Scheier et
al., 1989)

• Results
• Optimists
• Optimists rated as progressing better by staff
• Optimists more satisfied with medical care
• Optimists more likely to seek out

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Optimism and Recovery from Surgery (Scheier et
al., 1989)

• Results
• Six months post-operatively
• Optimists more likely to have resumed physical
  exercise
• Optimists
• Optimists
• Optimists higher rated quality of life

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Optimism and Recovery from Surgery (Scheier et
al., 1989)

• Conclusions
• 1. Optimists
• Faster recovery of some activities a week later
  (e.g., walking)
• Rated higher in prognosis by physicians
• Faster normalization of life by 6 months later

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Symptom Reports (Pennebaker, 2001)

• Fatigue
• Difficulty concentrating
• Racing heart
• Shortness of breath
• Headache
• Upset stomach
• Dizziness
• Muscle tension

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Symptom Reports (Pennebaker, 2001)

• Symptom reports
• Assumption is that they may tap
• However, many other influences on symptom reports

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Symptom Reports (Pennebaker, 2001)

• When do we attend to bodily states?
• Outside body, external stimuli
• Inside body, internal stimuli
• These directions compete

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Symptom Reports (Pennebaker, 2001)

• Competition of Attention Model
• 1.
• I.e., no external stimuli to compete for
  attention
• 2.
• Living alone
• Living in understimulating settings (e.g., rural
  environments)
• 3.
• Distraction by lights, sound, thoughts, etc.
• E.g., crying infant
• Playing sports

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Symptom Reports (Pennebaker, 2001)

• 1.
• 70 of first year medical students
• Report symptoms of disease
• 2.
• Mass scares about disease
• More people report symptoms, especially those
  consistent with the disease

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Symptom Reports (Pennebaker, 2001)

• Sex Differences
• Heart rate
• Stomach activity
• Blood pressure
• Blood glucose levels
• Cox et al (1985)
• Diabetics receiving glucose injections
• Manipulated levels
• Asked for estimates of amount injected
• Men
• Women

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Symptom Reports (Pennebaker, 2001)

• Sex
• Mass psychogenic illness
• Sick building syndrome
• Reading about symptoms

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Symptom Reports (Pennebaker, 2001)

• Neuroticism
• However,
• Health center visits
• Heart disease
• Etc.
• Thus, neuroticism a source of

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Symptom Reports (Pennebaker, 2001)

• Rape
• Death of spouse
• Etc.
• effects
• Increase symptom reports more than illness
• So traumatic experience a source of invalidity

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Symptom Reports (Pennebaker, 2001)

• Some ambiguous diseases perhaps with social
  origins
• Iron-poor blood
• Hypoglycemia
• Chronic fatigue syndrome
• Mitral valve prolapse
• Epstein-Barr
• SAD

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Symptom Reports (Pennebaker, 2001)

• Symptom reports
• However, many reports cannot be linked to any
  organic cause
• To what extent should we take seriously symptom
  reports?
• Benefits
• Costs
• Medical practitioners should probably realize
  that not all symptoms correspond to disease