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Health Psychology: Stress and Moderators of Stress

Definition of Terms

  • Stress: distress

    • Physical, psychological, emotional distress

  • Stressor: causes stress

  • Person-Environment Fit: assessment of personal resources vs. environmental demand

    • What you have vs what the environment demands from you

Theories of Stress

  • Walter Cannon: Fight or Flight

    • Fight: aggressive response to perceived stress

    • Flight: withdrawal/distracting activity

  • Freeze and Fawn

    • Freeze: similar to withdrawal “deer in the headlights”

    • Fawning: giving extra special attention to the point that it seems too much attention

      • Over the top response that involves attention to the person who is undergoing stress

      • Overreaction from third party point of view

      • Exaggerated attention and affection

      • Reaction from somebody removed from the stressful situation

  • Hans Selye’s General Adaptation Syndrome

    • All stressors produce the same patterns of physiological changes

    • 3 Phases

      • Alarm: an organism is mobilized to meet the threat

      • Resistance: an organism makes an effort to cope with the threat

        • Physical confrontation

      • Exhaustion: an organism fails to overcome the threat and the resources become depleted

    • Criticisms

      • Everyone respond to stress the same way

      • Not considering that stress is not only an outcome or endpoint

  • S.E. Taylor’s Tend-and-Befriend

    • Especially true of women

    • “We’re in the same boat” or “i feel better despite the situation because I’m not the only person in the situation”

The Stress Appraisal Process

  • Conscious process but not everybody appraises the situation, they just tend to react

  • Primary Appraisal: Harm, Threat, Challenge

    • Harmful: something damaging has already occurred; negative

    • Threat: something that may happen in the future; negative

    • Challenge: positive connotation; potential to overcome said challenge

    • Trying to distinguish between, harm, threat, challenge

    • If positive, some people may feel motivated to tackle the challenge

    • If negative, withdraw or retreat from the situation

  • Secondary Appraisal: Personal resources and Coping Mechanisms vs. Primary Appraisal of the stressful event

    • Evaluate whether you have enough resources and coping mechanisms to cope with something you consider as harm, threat, or challenge

    • 3 types of responses

      • Cognitive: you talk about your beliefs, value systems; take those into consideration and ask yourself “will this help me cope?”

      • Emotional: fear, frustration, anger, irritation, worry, disappointment, anxiety, embarrassment, annoyed, overwhelmed

      • Behavioral: panic, vent, rent, cry, confrontation, withdraw

The Physiology of Stress

  • Sympathetic Activation

    • Fight or flight

    • Preparing your body to confront stressful situations

    • Breathing gets more rapid, muscles are primed for action, increased blood flow to the muscles, heart rate goes up, from some people pupils contract

  • HPA Activation (hypothalamic pituitary adrenal)

    • Neurotransmitters come into play

    • Epinephrine, norepinephrine, serotonin

    • sympathetic nervous system and neurotransmitters associated with sympathetic activity: cortisol

    • Too much cortisol leads to inflammation in the body

      • Cushing syndrome

      • Obesity: stress eating, affects insulin production, decreased insulin sensitivity

    • Physiological framework is available for it

  • Stress Reactivity

    • Effects of long term stress = high levels of cortisol

  • Physiological recovery

    • Return to baseline

    • Parasympathetic system is responsible for this

  • Allostatic Load

    • Body’s response to prolonged exposure to stress

    • No definite structures associated with this

    • More general than HPA activity

Dimensions of Stressful Events

  • Negative events

    • The more negative, the more it will affect us

  • Uncontrollable events

    • Acts of God

  • Ambiguous events

    • Vague events

  • Overload

    • Overload of physical, emotional, psychological stress

    • They would perceive that as more stressful than any other event

  • Factors that would influence how you perceive stressful events

Chronic Stress and Health

  • Effects of chronic stress

  • Stress and the workplace

  • Work + Sedentary lifestyle

  • Overload

  • Ambiguity and Role conflict

  • Work + Multiple Roles

Coping with Stress

  • No two people handle stress in the same way.

  • Personality and Coping

    • Negative affectivity (Neuroticism): pervasive; anxiety, depression, hostility

    • Type D personality: experiences negative emotions yet inhibits the expression of these emotions

      • Martyrs: they don’t express their negative emotions

    • Disease-prone personality: the psychological distress that often involves depression, anger, hostility and anxiety is at the core of this “personality type”; individual is more prone to “all causes” mortality

Caution!!!

  • Negativity may lead to the false impression of ill health when there is no evidence of such.

  • Negativity = worry, “awareness” of symptoms = new or existing health condition

  • In summary, people who are chronically negative MAY be more likely to get sick on occasion BUT their symptoms MAY or MAY NOT actually be indicative of ill health.

Coping Resources

  • Optimism

    • healthier immune system;

    • optimists often seek out social support

    • reframe stressful situations in a positive light;

    • more active and persistent coping efforts;

    • sense of self-control;

    • problem-focused coping

  • Self-control vs. Self-efficacy

    • Self-control: belief that one can control one’s behavior; can influence one’s environment; can bring about desired outcomes

    • Self-efficacy: narrower perception that one can take necessary action/s to obtain specific outcome in a specific situation

  • High self-esteem

  • Ego strength: dependability, trust, and lack of impulsivity

  • Conscientiousness: deal with stress proactively

  • Self-confidence and easy-going disposition

  • Intelligence: street smarts

  • Emotional stability

Resilience

  • Ability to bounce back from negative experiences (emotional and otherwise) and adapt to whatever changes result from stressful experiences.

COPING STYLE

  • Tendency to deal with stressful events in a particular way

  • Similar to personality traits because it is a characterization of how a person behaves in general, yet different from personality traits in that coping style only becomes evident in times of STRESS.

Specific Coping Styles

  • Proactive coping: requires the ability to anticipate and detect stressors, coping skills, and self-regulatory skills (control, direct, correct actions based on whether you end up moving toward or away from your goals).

  • Avoidant coping style vs.  Approach coping style

    • Avoidant coping = withdrawal; closest to denial

      • Not deal with the stressful situation

      • “If I don’t see it, it’s not real”

    • Approach coping = meeting/facing problems HEAD ON

      • Closest to problem-based coping

  • Problem-focused vs. Emotion-focused coping style: problem-focused coping is attempting to do something constructive about stressful situations; emotion-focused coping may or may not result in beneficial ways of dealing with stress (e.g. ruminating vs. emotional-approach coping)

    • Emotion-focused coping = efforts to regulate emotions experienced because of stressful event

      • Going by your feelings/emotions

    • Emotional approach coping = clarifying, focusing on, and working through emotions brought on by a stressor; results in beneficial effects on stress regulatory systems and helps people AFFIRM important aspects of “the self”/identity

When is coping successful?

  • Reduces harmful environmental conditions

  • Tolerate or adjust to negative events

  • Maintain a positive self-image

  • Maintain emotional equilibrium

    • Emotional equilibrium = emotionally stable state

  • Continue satisfying relationships with others

  • Successful coping = Enhances prospects of recovery

    • Successful coping = enhanced recovery

Social support

  • Types of social support

    • Tangible assistance – material support

    • Informational support – education, information

    • Emotional support

    • Invisible support – “giver” is anonymous

  • Forms of social support

    • Confidant

    • Marriage

    • Support from family

    • Support from community

  • Social support is most beneficial when the support that is given MATCHES or is responsive to the needs of the receiver; also beneficial if the “giver” is known to the receiver.

Coping interventions

  • Mindfulness training

  • Expressive writing: eliminates rumination or obsession about negative or traumatic events

  • Relaxation training

  • Time management and planning

  • Assertiveness training

  • Regular exercise: Endorphins! Remember LEGALLY BLONDE!!!

S

Health Psychology: Stress and Moderators of Stress

Definition of Terms

  • Stress: distress

    • Physical, psychological, emotional distress

  • Stressor: causes stress

  • Person-Environment Fit: assessment of personal resources vs. environmental demand

    • What you have vs what the environment demands from you

Theories of Stress

  • Walter Cannon: Fight or Flight

    • Fight: aggressive response to perceived stress

    • Flight: withdrawal/distracting activity

  • Freeze and Fawn

    • Freeze: similar to withdrawal “deer in the headlights”

    • Fawning: giving extra special attention to the point that it seems too much attention

      • Over the top response that involves attention to the person who is undergoing stress

      • Overreaction from third party point of view

      • Exaggerated attention and affection

      • Reaction from somebody removed from the stressful situation

  • Hans Selye’s General Adaptation Syndrome

    • All stressors produce the same patterns of physiological changes

    • 3 Phases

      • Alarm: an organism is mobilized to meet the threat

      • Resistance: an organism makes an effort to cope with the threat

        • Physical confrontation

      • Exhaustion: an organism fails to overcome the threat and the resources become depleted

    • Criticisms

      • Everyone respond to stress the same way

      • Not considering that stress is not only an outcome or endpoint

  • S.E. Taylor’s Tend-and-Befriend

    • Especially true of women

    • “We’re in the same boat” or “i feel better despite the situation because I’m not the only person in the situation”

The Stress Appraisal Process

  • Conscious process but not everybody appraises the situation, they just tend to react

  • Primary Appraisal: Harm, Threat, Challenge

    • Harmful: something damaging has already occurred; negative

    • Threat: something that may happen in the future; negative

    • Challenge: positive connotation; potential to overcome said challenge

    • Trying to distinguish between, harm, threat, challenge

    • If positive, some people may feel motivated to tackle the challenge

    • If negative, withdraw or retreat from the situation

  • Secondary Appraisal: Personal resources and Coping Mechanisms vs. Primary Appraisal of the stressful event

    • Evaluate whether you have enough resources and coping mechanisms to cope with something you consider as harm, threat, or challenge

    • 3 types of responses

      • Cognitive: you talk about your beliefs, value systems; take those into consideration and ask yourself “will this help me cope?”

      • Emotional: fear, frustration, anger, irritation, worry, disappointment, anxiety, embarrassment, annoyed, overwhelmed

      • Behavioral: panic, vent, rent, cry, confrontation, withdraw

The Physiology of Stress

  • Sympathetic Activation

    • Fight or flight

    • Preparing your body to confront stressful situations

    • Breathing gets more rapid, muscles are primed for action, increased blood flow to the muscles, heart rate goes up, from some people pupils contract

  • HPA Activation (hypothalamic pituitary adrenal)

    • Neurotransmitters come into play

    • Epinephrine, norepinephrine, serotonin

    • sympathetic nervous system and neurotransmitters associated with sympathetic activity: cortisol

    • Too much cortisol leads to inflammation in the body

      • Cushing syndrome

      • Obesity: stress eating, affects insulin production, decreased insulin sensitivity

    • Physiological framework is available for it

  • Stress Reactivity

    • Effects of long term stress = high levels of cortisol

  • Physiological recovery

    • Return to baseline

    • Parasympathetic system is responsible for this

  • Allostatic Load

    • Body’s response to prolonged exposure to stress

    • No definite structures associated with this

    • More general than HPA activity

Dimensions of Stressful Events

  • Negative events

    • The more negative, the more it will affect us

  • Uncontrollable events

    • Acts of God

  • Ambiguous events

    • Vague events

  • Overload

    • Overload of physical, emotional, psychological stress

    • They would perceive that as more stressful than any other event

  • Factors that would influence how you perceive stressful events

Chronic Stress and Health

  • Effects of chronic stress

  • Stress and the workplace

  • Work + Sedentary lifestyle

  • Overload

  • Ambiguity and Role conflict

  • Work + Multiple Roles

Coping with Stress

  • No two people handle stress in the same way.

  • Personality and Coping

    • Negative affectivity (Neuroticism): pervasive; anxiety, depression, hostility

    • Type D personality: experiences negative emotions yet inhibits the expression of these emotions

      • Martyrs: they don’t express their negative emotions

    • Disease-prone personality: the psychological distress that often involves depression, anger, hostility and anxiety is at the core of this “personality type”; individual is more prone to “all causes” mortality

Caution!!!

  • Negativity may lead to the false impression of ill health when there is no evidence of such.

  • Negativity = worry, “awareness” of symptoms = new or existing health condition

  • In summary, people who are chronically negative MAY be more likely to get sick on occasion BUT their symptoms MAY or MAY NOT actually be indicative of ill health.

Coping Resources

  • Optimism

    • healthier immune system;

    • optimists often seek out social support

    • reframe stressful situations in a positive light;

    • more active and persistent coping efforts;

    • sense of self-control;

    • problem-focused coping

  • Self-control vs. Self-efficacy

    • Self-control: belief that one can control one’s behavior; can influence one’s environment; can bring about desired outcomes

    • Self-efficacy: narrower perception that one can take necessary action/s to obtain specific outcome in a specific situation

  • High self-esteem

  • Ego strength: dependability, trust, and lack of impulsivity

  • Conscientiousness: deal with stress proactively

  • Self-confidence and easy-going disposition

  • Intelligence: street smarts

  • Emotional stability

Resilience

  • Ability to bounce back from negative experiences (emotional and otherwise) and adapt to whatever changes result from stressful experiences.

COPING STYLE

  • Tendency to deal with stressful events in a particular way

  • Similar to personality traits because it is a characterization of how a person behaves in general, yet different from personality traits in that coping style only becomes evident in times of STRESS.

Specific Coping Styles

  • Proactive coping: requires the ability to anticipate and detect stressors, coping skills, and self-regulatory skills (control, direct, correct actions based on whether you end up moving toward or away from your goals).

  • Avoidant coping style vs.  Approach coping style

    • Avoidant coping = withdrawal; closest to denial

      • Not deal with the stressful situation

      • “If I don’t see it, it’s not real”

    • Approach coping = meeting/facing problems HEAD ON

      • Closest to problem-based coping

  • Problem-focused vs. Emotion-focused coping style: problem-focused coping is attempting to do something constructive about stressful situations; emotion-focused coping may or may not result in beneficial ways of dealing with stress (e.g. ruminating vs. emotional-approach coping)

    • Emotion-focused coping = efforts to regulate emotions experienced because of stressful event

      • Going by your feelings/emotions

    • Emotional approach coping = clarifying, focusing on, and working through emotions brought on by a stressor; results in beneficial effects on stress regulatory systems and helps people AFFIRM important aspects of “the self”/identity

When is coping successful?

  • Reduces harmful environmental conditions

  • Tolerate or adjust to negative events

  • Maintain a positive self-image

  • Maintain emotional equilibrium

    • Emotional equilibrium = emotionally stable state

  • Continue satisfying relationships with others

  • Successful coping = Enhances prospects of recovery

    • Successful coping = enhanced recovery

Social support

  • Types of social support

    • Tangible assistance – material support

    • Informational support – education, information

    • Emotional support

    • Invisible support – “giver” is anonymous

  • Forms of social support

    • Confidant

    • Marriage

    • Support from family

    • Support from community

  • Social support is most beneficial when the support that is given MATCHES or is responsive to the needs of the receiver; also beneficial if the “giver” is known to the receiver.

Coping interventions

  • Mindfulness training

  • Expressive writing: eliminates rumination or obsession about negative or traumatic events

  • Relaxation training

  • Time management and planning

  • Assertiveness training

  • Regular exercise: Endorphins! Remember LEGALLY BLONDE!!!