Chapter 13 Stress, Coping, and Health

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Chapter 13Stress, Coping, and Health
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The Relationship Between Stress and Disease

• Contagious diseases vs chronic diseases
• Biopsychosocial model
• Health psychology
• Health promotion and maintenance
• Discovery of causation, prevention, and treatment

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Figure 13.1 Changing patterns of illness. Trends
in the death rates for various diseases during
the 20th century reveal that contagious diseases
(shown in blue) have declined as a threat to
health. However, the death rates for
stress-related chronic diseases (shown in red)
have remained quite high. The pie chart (inset)
shows the results of these trends three chronic
diseases (heart disease, cancer, and stroke)
account for 61.9 of all deaths.
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Stress An Everyday Event

• Major stressors vs. Routine hassles
• Cumulative nature of stress
• Cognitive appraisals
• Major types of stress
• Frustration blocked goal
• Conflict two or more incompatible motivations
• Approach-approach, approach-avoidance,
  avoidance-avoidance
• Change having to adapt
• Holmes and Rahe Social Readjustment Rating
  Scale Life Change Units
• Pressure expectations to behave in certain ways
• Perform/conform

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Figure 13.4 Overview of the stress process. A
potentially stressful event, such as a major
exam, elicits a subjective appraisal of how
threatening the event is. If the event is viewed
with alarm, the stress may trigger emotional,
psychological, and behavioral reactions, as
peoples response to stress is multidimensional.
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Figure 13.2 Types of conflict. Psychologists have
identified three basic types of conflict. In
approach-approach and avoidance-avoidance
conflicts, a person is torn between two goals. In
an approach-avoidance conflict, there is only one
goal under consideration, but it has both
positive and negative aspects.
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Responding to Stress Emotionally

• Emotional Responses
• Annoyance, anger, rage
• Apprehension, anxiety, fear
• Dejection, sadness, grief
• Emotional response and performance
• The inverted-U-hypothesis

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Figure 13.5 Arousal and performance. Graphs of
the relationship between emotional arousal and
task performance tend to resemble an inverted U,
as increased arousal is associated with improved
performance up to a point, after which higher
arousal leads to poorer performance. The optimal
level of arousal for a task depends on the
complexity of the task. On complex tasks, a
relatively low level of arousal tends to be
optimal. On simple tasks, however, performance
may peak at a much higher level of arousal.
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Responding to Stress Physiologically

• Physiological Responses
• Fight-or-flight response
• Selyes General Adaptation Syndrome
• Alarm, resistance, exhaustion

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Figure 13.6 Brain-body pathways in stress. In
times of stress, the brain sends signals along
two pathways. The pathway through the autonomic
nervous system controls the release of
catecholamine hormones that help mobilize the
body for action. The pathway through the
pituitary gland and the endocrine system controls
the release of corticosteroid hormones that
increase energy and ward off tissue inflammation.
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Responding to Stress Behaviorally

• Behavioral Responses
• Frustration-aggression hypothesis
• Catharsis
• Defense mechanisms
• Constructive coping

Launch Video
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Effects of Stress Behavioral and Psychological

• Impaired Task performance
• Burnout
• Posttraumatic Stress Disorders (PTSD)
• Psychological problems and disorders

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Figure 13.8 The prevalence of traumatic
events. People tend to think that traumatic
events are relatively unusual and infrequent, but
research by Stein et al. (1997) suggests
otherwise. They interviewed over 1000 people in
Winnipeg, and found that 74.2 of the women and
81.3 of the men reported experiencing at least
one highly traumatic event. The percentage of
respondents reporting specific types of traumatic
events are summarized in this graph.
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Effects of Stress Physical

• Psychosomatic diseases
• Type A behavior and heart disease
• 3 elements
• strong competitiveness
• impatience and time urgency
• anger and hostility
• Stress and immune functioning
• Reduced immune activity

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Figure 13.10 Mechanisms that may link Type A
personality to heart disease. Explanations for
the apparent link between Type A behavior and
heart disease are many and varied. Four widely
discussed possibilities are summarized in the
middle column of this diagram.
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Figure 13.12 The stress-illness correlation. One
or more aspects of personality, physiology, or
memory could play the role of a postulated third
variable in the relationship between high stress
and high incidence of illness. For example,
neuroticism may lead some subjects to view more
events as stressful and to remember more illness,
thus inflating the apparent correlation between
stress and illness.
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Factors Moderating the Impact of Stress

• Social Support
• Increased immune functioning
• Optimism
• More adaptive coping
• Pessimistic explanatory style
• Conscientiousness
• Fostering better health habits
• Autonomic reactivity
• Cardiovascular reactivity to stress

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Health-Impairing Behaviors

• Smoking
• Poor nutrition
• Lack of exercise
• Alcohol and drug use
• Risky sexual behavior
• Transmission, misconceptions, and prevention of
  AIDS

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Figure 13.19 Physical fitness and
mortality. Blair and colleagues (1989) studied
death rates among men and women who exhibited
low, medium, or high fitness. As you can see,
fitness was associated with lower mortality rates
in both sexes.
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Figure 13.15 HIV transmission worldwide. In the
United States, about 80 of HIV transmission thus
far has occurred among gay men or intravenous
drug users, perhaps leading to misconceptions
about the ease of transmission via heterosexual
relations. However, in the world as a whole,
heterosexual relations are the predominant mode
of transmission, as these data show. (Data from
Mann et al., 1992)
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Reactions to Illness

• Seeking treatment
• Ignoring physical symptoms
• Communication with health care providers
• Barriers to effective communication
• Following medical advice
• Noncompliance

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Figure 13.17 Albert Elliss A-B-C model of
emotional reactions. Although most people are
prone to attribute their negative emotional
reactions directly to events, Ellis argues that
people feel the way they think. According to
Ellis, the key to managing stress is to change
ones appraisal of stressful events.
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