Class 12

1. Personality and Coping I: Mediation, Moderation, Negative Affect, Self-Efficacy and Endogenous Opiates Class 12

2. Relation Between Stress and Health Not Perfect

3. Mediators Mediator: If A  B  C, then “B” is what mediates the relation between A and C. B A C Immunocompromise Stress Illness

4. A C B A * B Moderators Predictor Stress Illness Social Isolation Stress*Social Isolation Moderator Moderation

5. Moderators of the Stress and Health Connection Physical Constitution 1. Genetic make-up (infant reactivity study) 2. Age (very young, very old) 3. Material resources Behavior 1. Sleep 2. Diet 3. Substance abuse 4. Isolation 5. Exercise Personality

6. The Coping Sequence Stressor Primary Appraisal (Harm, Threat, Challenge) External Moderators Secondary Appraisal Tangibles External Resources and Impediments Internal Moderators Social Support Typical coping style Other life stressors Internal Resources and Impediments Other personality factors Stress Response

7. The Coping Sequence Stressor Primary Appraisal (Harm, Threat, Challenge) Moderators Tangibles External Resources and Impediments Moderators Social Support Typical coping style Internal Resources and Impediments Other life stressors Other personality factors Secondary Appraisal Coping Tasks/Goals Coping Outcomes

8. Negative Affect (Watson, Clark, & Tellegen) Defined: Pervasive negative mood marked by anxiety, depression, and hostility. Find many situations difficult to manage Resort to unhealthy coping behaviors (such as?) Related to poor health: asthma, arthritis, ulcers, headaches, CHD Related to excess complaining: a. More symptoms b. Higher use of health services c. Higher rates of self-reported illness d. These people may compromise validity of self-reported illness

9. Self Efficacy Robt. Bandura

10. About Reading Research Articles 1. Focus on Introduction and Discussion 2. Skim "Methods", know what was done. 3. Skip over "Results" section

11. Efficacy, Stress, and Immunocompetence Background: Animals exposed to stressor (shock) Group A: Believes has control Group B: Believes has NO control Outcome: Opioids in system Which animals produce MORE opioids? Group B--No Control

12. Efficacy, Stress, and Immunocompetence Stress --> ______ path --> ______ stim --> _____ --> opiods How do opioids affect immune system? ____________ Thus, less control --> ___more stress OR ___ less stress --> ___more opioids OR ___ less opioids --> ___ Immunocompetence OR ___ Immunocompromise cortisol ACTH adrenal depress it X X X

13. Physiology of Stress 1.SAM: Sympathetic-adrenomedullary Event  cortex  hypothalamus  SNS  adrenal medulla   catecholamines  charged feeling increased BP, HR, etc. SAM Corresponds to Cannon's stress model 2. HPA: Hypothlamic-pituitary-adreocortical Event  cortex  hypothalamus  coritcotrophin releasing factor (CRF)  pituitary adrencorticotropic hormone (ACTH)  adrenal cortex corticosteriods conserves carbos  reduces inflammation HPA corresponds to Selye's stress model

14. Evidence that Efficacy Moderates Stress --> Illness Connection in Humans Bandura, Cioffi, Taylor, & Brouillard, 1988 Predicted model: Failure --> stress --> opioids --> less pain --> (immunocompromise) Four groups: 1. Success, pain, opioid blocker 2. Success, pain, no opioid blocker 3. Failure, pain, opioid blocker 4. Failure, pain, no opioid blocker

15. Efficacy Manipulation High Efficacy Group (2 X 7 + 15) (9 X 8 - 12) (73 - 15 X 3) At own pace Low Efficacy Group (2 X 7 + 15) (9 X 8 - 12) (73 - 15 X 3) At preset, and difficult, pace Change in self-perceived math efficacy

16. Psychological Effects of Math-Test Manipulation High Efficacy Condition Low Efficacy Condition

17. Opiate Blockage Purpose: If stress increases opiates, and opiates reduce pain, then ___High efficacy OR ___ Low efficacy condition will have higher pain thresholds (i.e., be better able to withstand pain longer)? HOWEVER, if opiates are blocked, which group should have higher pain thresholds, ____ High efficacy OR ___ Low efficacy? X X To show this, need to block opiates to some subjects Naloxone: Opiate antagonist; 100% effective Subs get Naloxone or saline. Why use saline?

18. Experiment Design and Predictions Saline Naloxone (Placebo) (Opiate Blocker) High Efficacy Low Efficacy Moderate Moderate Low Tolerance High Tolerance Pain Threshold (Ability to Tolerate Hand in Freezing Water)

19. Evidence that Efficacy Moderates Stress --> Illness Connection in Humans Bandura, Cioffi, Taylor, & Brouillard, 1988

20. Health Outcomes Questions 1. Compared to most other college students, what is your risk of an alcohol- related injury? 2. Compared to most other college students, what is your risk of getting into a car accident?

21. Risk of Alcohol Injury, Compared to Most Students n = 48 Mean = 2.46 Median = 2.00 Mode = 1 SD = 1.64

22. Denial and Coping Psychological defense: Minimize or deny existence of threat Is denial good or bad? Good* _______ Early in crisis _______ Chronic (ongoing) Bad On-going denial can stop people from taking necessary action. NMAD = Near Miss Asthma Death Who denies more: ___ Asthmatics who experienced NMAD ___ Regular Asthmatics ___ Non Asthmatics X * Sometimes

23. Denial Among NMAD Survivors, “Regular” Asthmatics, and Non-Asthmatics Yellowlees & Ruffin, 1989

24. Denial and Health Indices Among NMAD Survivors with or without Pre-existing Psychological Problems Yellowlees & Ruffin, 1989 GHQ = Gen. Health Quest’aire MHQ = Mental Health Quest’aire QOL = Quality of Life Hypervent = Hyperventilation Episodes

25. Evidence of Improved Marital Relations Following NMAD (????) “He has been less violent since the attack. He plays with me now by twisting my arm up my back as a joke rather than by badly bruising me”.

26. Optimists vs. Pessimists Optimists 1. Expect positive outcomes 2. Expect to cope with adversity Pessimists 1. Expect negative outcomes 2. Do not expect to cope with adversity

27. Pessimistic vs. Optimistic Attribution Styles A. Internal vs. External Cause B. Stable vs. Transitory Cause C. Global vs. Specific Cause

28. Optimistic and Pessimistic Explanatory Styles Success Failure Internal Cause Optimist Pessimist External Cause Pessimist Optimist Stable Cause Optimist Pessimist Transitory Cause Pessimist Optimist

29. Explanatory Causes and Styles I won the tennis match because my opponent wasn’t trying hard. ___Internal cause ___ External cause I lost my keys because I'm such a flake. ___Internal cause ___ External cause I showed up late for my date because Ididn’t plan far enough in advance.. ___ Stable Cause ___ Transitory Cause I showed up late for my date because I am so bad at planning. ___ Stable Cause ___ Transitory Cause My cholesterol went up because I’m not exercising. ___ Specific Cause ___ Global Cause My cholesterol went up because I’m a lazy slob. ___ Specific Cause ___ Global Cause X X X X X X

30. Optimism Measure Scheier, M.F., Carver, C.S., & Bridges, M.W. (1994)