Chapter 11 Health, Stress, and Coping

Chapter 11Health, Stress, and Coping

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

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.

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

Table 11.2

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

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

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

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

Threats and Frustration • Problem-Focused Coping: Managing or altering the distressing situation • Emotion-Coping Focusing: Trying to control one’s 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

Figure 11.3 FIGURE 11.3 Frustration and common reactions to it.

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 one’s 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)

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

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

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.

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

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

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 one’s 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

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

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.

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 one’s environment • One method to combat learned helplessness and depression

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 can’t handle your responsibilities and feel overwhelmed.

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 (LCU’s): Numerical values assigned to each life event on the SRRS

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

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

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.

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

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

General Adaptation Syndrome (GAS) • Series of bodily reactions to prolonged stress; occurs in three stages

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

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

Stage of Exhaustion • Stage of Exhaustion: Body’s resources are drained and stress hormones are depleted, possibly resulting in: • Psychosomatic disease • Loss of health • Complete collapse

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

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

Stress Management (cont'd) • 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

Figure 11.9 FIGURE 11.9 The Stress Game. (Adapted from Rosenthal and Rosenthal, 1980.)

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

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

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

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

Chapter 11 Health, Stress, and Coping