Health Psychology

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Health Psychology

• Study of SOCIAL, BEHAVIORAL, COGNITIVE, and
  EMOTIONAL factors that influence Health

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GOALS of HEALTH PSYCHOLOGY

• 1. Promote and maintain health (e.g., stop
  smoking, buckle belts).
• 2. Prevent and treat illness (e.g. reduce High
  Blood pressure).
•  
• 3. Focus on cause and detection of illness
  influence of personality, cognitive processes.
• 4. Improve the health care system/health policy.

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Health Psychology

• Looks at how Psychological factors influence
• OF ILLNESS

DIAGNOSIS
TREATMENT
PREVENTION
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What are your health risks?For each item, answer
YES or No.
1. I believe if I feel well I must be healthy.
2. My weight is not within the range that the charts say it should be.
3. I smoke cigarettes
4. My drinking would not qualify as moderate I either do not drink or I drink too much to be considered a moderate drinker.
5. I rarely get 7 or 8 hours of sleep.
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What are your health risks?For each item, answer
YES or No.
6. I do not follow a regular exercise program.
7. I believe that most disease have a genetic base.
8. I believe that modern medicine will find cures for most diseases before I am old enough to be affected by these diseases.
9. As long as I am not overweight, I believe that my diet will not affect my health.
10. I can wait until I am older to develop a healthier lifestyle.
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Estimated contributions of different factors to
HEALTH status.
BEHAVIOR
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is the single most
preventable cause of mortality and morbidity in
United States
Smoking
8
Nine leading causes of death in the United
States. 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. Although
suicide is not shown here, it is the seventh most
common cause of death. On this graph, suicides
are included in the categories death by toxic
agents, firearms, motor vehicles, and drugs.
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Research on Mind-Body Connections in the Causes
and Treatments of Illness

• 1/3 of hospitalized medical patients with chronic
  conditions suffer from psychological disorders
• Compared to 2-4 of the general population

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New Health Perspectives
The major diseases of today are heart disease,
cancer, and lung disease
Preventable through modifications in behavior
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Biomedical Model Replaced

• BIOPSYCHOSOCIAL Model new approach
• Health and Illness are products of biological,
  psychological, and social factors

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New Main Approach

• The Biopsychosocial Model
• views health and illness as the product of a
  combination of factors including
• Biological factors (e.g., genetic
  predisposition),
• Psychological factors (e.g., personality,
  lifestyle, stress, health beliefs), and
• Social factors (e.g., cultural influences, family
  relationships, social support).

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Major health-promoting behaviors
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Major health-promoting behaviors
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HEALTH PSYCHOLOGY

• SAMPLE ISSUES
• why do people smoke cigarettes,
• drink alcohol,
• or use drugs
• how can we help people to exercise,
• stop smoking, and lose weight,
• HOW CAN WE GET PEOPLE TO FOLLOW DOCTORS ORDERS?

How can we reduce stress?
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STRESS IS LIKELY TO OCCUR WHENEVER A PERSON HAS
TO MAKE ADJUSTMENTS OR ADAPT THEIR BEHAVIOR TO
THE ENVIRONMENT
http//www.youtube.com/watch?vMQBhnTj7uDE STRESS
DEF. BODYS PHYSICAL RESPONSE TO A PERCEIVED
DEMAND OR THREAT
http//www.youtube.com/watch?vCPpv0VbOnn4feature
relmfu PT 2 COGNITIONS
http//www.youtube.com/watch?vulUnY495SyYfeature
relmfu ST MGMNT
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CHANGE in life that requires numerous
READJUSTMENTS can challenge the limits of
our capabilities or challenge our self-concepts
and thus can be perceived as STRESSFUL
ANY
EVEN POSITIVE changes
PERSON FEELS THEY DONT HAVE THE RESOURCES TO
DEAL WITH THE STRESS IN AN EFFECTIVE WAY.
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any event or
situation that requires people to adjust to it in
some way.
STRESSOR
It can even be imaginary student imagines the
test will be very hard.
Fearful anticipation
is usually worse than actual realization

• Stressors can be internal (thoughts, beliefs,
  attitudes ) or external (loss, tragedy, change).

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STRESSOR may be
A. PHYSICAL
HIGH TEMP,FATIGUE, INFECTION, PAIN
depression, pessimism, financial debt
argue with lover, loneliness
B. PSYCHOLOGICAL
C. COMBINATION OF BOTH impact of the
psychological stress typically experienced in
starting a new job might be exaggerated if the
new job holder is also battling a cold (a
physical stress)
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STRESS IS A NORMAL PART OF EVERY PERSONS LIFE
ABSENCE OF STRESS
DEATH
STRESS IS NOT ALWAYS BAD
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THERE ARE BOTH BENEFICIAL

(EUSTRESS)

AND NON-BENEFICIAL TYPES OF STRESS.
Ex. moderate exercise
(DISTRESS)
negative events often involve loss and can
threaten self-esteem or sense of mastery of the
world
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Mild forms of stress can be MOTIVATING,
STIMULATING, and even DESIRABLE
Severe stress can promote physical, emotional,
and behavioral problems.
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THE SAME SITUATION IS NOT STRESSFUL TO EVERYONE.
Ex. WORK, CHILDBIRTH, WEDDING, PUBLIC SPEAKING,
TEST TAKING
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ULTIMATELY STRESS DEPENDS UPON HOW A SITUATION IS.
PERCEIVED
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SEYMOUR EPSTEIN - the time of greatest stress is
not necessarily when danger is at its height
PARACHUTIST Greatest stress was when
they were anticipating making the jump
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RICHARD LAZARUS COGNITIVE-MEDIATIONAL THEORY
SAYS THE WAY PEOPLE THINK ABOUT AND APPRAISE A
STRESSOR IS A MAJOR FACTOR IN HOW STRESSFUL THAT
PARTICULAR STRESSOR BECOMES.
LAZARUS SAYS THERE IS A 2 STEP PROCESS IN
ASSESSING THE DEGREE OF THREAT OR HARM OF A
STRESSOR AND HOW ONE SHOULD REACT TO THAT
STRESSOR.
1. PRIMARY APPRAISAL
DEGREE OF THREAT OR HARM
2. SECONDARY APPRAISAL
-RESOURCES YOU HAVE FOR COPING
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1. PRIMARY APPRAISAL

INVOLVES ESTIMATING THE SEVERITY OF THE STRESSOR
AND CLASSIFYING IT AS A THREAT, A CHALLENGE, OR A
HARM OR LOSS THAT HAS ALREADY OCCURRED. IS THIS
EVENT POSITIVE, NEUTRAL OR NEGATIVE AND IF
NEGATIVE, HOW BAD?
2. SECONDARY APPRAISAL
IF
THREAT OR HARMFUL EFFECT IS PERCEIVED, YOU THEN
MUST ESTIMATE THE RESOURCES YOU HAVE AVAILABLE
FOR COPING WITH THE STRESSOR.
IF RESOURCES ARE PERCEIVED AS ADEQUATE OR
ABUNDENT, THE DEGREE OF STRESS WILL BE
CONSIDERABLY LESS THAN IF RESOURCES ARE MISSING
OR LACKING.
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Lazarus Cognitive Appraisal View of Stress
Deciding if a situation is relevant or
irrelevant, positive or threatening
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Cognitive Model of StressLazarus

• Primary appraisal Is there a potential threat?
• Outcome Is it irrelevant, good, or stressful?
• If stressful, evaluate further
• Harm-loss amount of damage already caused.
• Threat expectation for future harm.
• Challenge opportunity to achieve growth, etc

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STRESS REACTIONS
How Can I Know When Im Under Stress?
A. PHYSICAL
B. EMOTIONAL
C. BEHAVIORAL
D. COGNITIVE
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How Can I Know When Im Under Stress?
A. PHYSICAL

• Physical symptoms of stress may include

• stomach or bowel upset
• headaches
• backaches
• muscle tension
• change in eating habits loss of appetite or
  overeating
• restlessness/irritability
• Sleep problems
• Unusual fatigue
• Frequent colds, chest pains, nausea

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STRESS REACTIONS
A. PHYSICAL
B. EMOTIONAL

• Emotional symptoms of stress may include

• increased anger
• Frustration
• depression
• emotional outbursts
• excessive fear
• worry
• increased anxiety

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STRESS REACTIONS
A. PHYSICAL
B. EMOTIONAL
C. BEHAVIORAL

• behavioral symptoms of stress may include

• clumsiness being accident prone
• increased illness
• more frequent use of cigarettes, alcohol, or
  drugs
• withdrawal from usual activities

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Behavioral Stress Symptoms cont.YawningTalking
too fast or too loudFiddling and twitching,
nail biting, grinding teeth, drumming
fingers,pacing, etc.Bad moodsDefensivenessIr
rationalityBeing irritableBeing
criticalAggressionOverreaction and reacting
emotionally
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Behavioral Stress Symptoms cont.
lack of enthusiasm for family, school, work or
life withdrawal

• Reduced personal effectiveness
• Being more forgetful Making more mistakes
• Being unreasonably negative anger, fatigue
• Making less realistic judgements
• Being more accident prone
• Changing work habits,Increased absenteeism

insomnia, hypersomnia, . Neglect of personal
appearance change in eating habits,
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STRESS REACTIONS
A. PHYSICAL
B. EMOTIONAL
C. BEHAVIORAL
D. COGNITIVE

• cognitive symptoms of stress may include

• decreased ability to concentrate
• memory problems/forgetfulness
• making more mistakes
• Confusion
• problems in decision making
• ruminative/obsessive thoughts
• lose your sense of humor

nightmares
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Effects of Stress

• Stress takes its toll on our bodies (stomach
  aches, headaches, backaches)
• on our interest in, productivity, and enjoyment
  of life and work
• and may contribute to more serious conditions
  such as ulcers, high blood pressure, cancer,
  heart attack, or stroke.

8
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Our goal is not to eliminate stress but to learn
how to . Begin with
educating yourself.
manage it
http//www.youtube.com/watch?vS7_rsBIokA8
STRESS OVERVIEW
http//www.youtube.com/watch?vQ4LQCJNWmOgfeature
related
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STRESS IMMUNE SYSTEM
WHEN MENTALLY OR PHYSICALLY STRESSED, YOUR BODY
UNDERGOES SEVERAL PHYSIOLOGICAL CHANGES
RELEASE OF IS
DIRECTLY RELATED TO IMPAIRMENT OF THE IMMUNE
SYSTEM.
CORTISOL
IMPAIRED IMMUNE SYSTEM IS ASSOCIATED WITH
INCREASED RISK OF DISEASE
EX. COLITIS, PERIODONTAL DISEASE, HEART DISEASE,
CANCER, ALZHEIMERS DISEASE, COMMON
COLD
CORTISOL
STRESS
IMPAIRED IMMUNE SYSTEM
INCREASED RISK OF DISEASE
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MEASURING STRESSORS

• SOCIAL READJUSTMENT RATING SCALE (SRRS)

HOLMES AND RAHE
Stressfulness of the situation depends on the
amount of CHANGE person undergoes
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Good things that happen to us as well as the bad
things can cause stress

• SOCIAL READJUSTMENT RATING SCALE (SRRS)

adjustive demands
because they involve
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• SOCIAL READJUSTMENT RATING SCALE (SRRS)

• Studied the relationship between stressful life
  events and the development of illness

High scores on S.R.R.S is associated with
increased risk of accident or illness
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Ss rated the readjustment required by each event
with the assumption that marriage was worth 50
points on a 100 point scale

• SOCIAL READJUSTMENT RATING SCALE (SRRS)

Score of 200-299 was associated with 50 percent
INCREASED RISK OF ILLNESS OR ACCIDENT
Score gt 300 80 percent INCREASED RISK OF
ILLNESS OR ACCIDENT

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STUDENT STRESS RATING SCALE

• The following are events that occur in the life
  of a college student. Place a check in the
  left-hand column for each of those events that
  has happened to you during the last 12 months.
• ___ Death of a close family member - 100 points
  
• ____ Jail term - 80 points
• ____ Final year or first year in college - 63
  points
• ____ Pregnancy (to you or caused by your) - 60
  points
• ____ Severe personal illness or injury - 53
  points
• ____ Marriage - 50 points
• ____ Any interpersonal problems - 45 points
• ____ Financial difficulties - 40 points
• ____ Death of a close friend - 40 points
• ____ Arguments with your roommate (more than
  every other day) - 40 points
• ____ Major disagreements with your family - 40
  points
• ____ Major change in personal habits - 30 points

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• ____ Change in living environment - 30 points
• ____ Beginning or ending a job - 30 points
• ____Problems with your boss or professor - 25
  points
• ____ Outstanding personal achievement - 25 points
• ____ Failure in some course - 25 points
• ____ Final exams - 20 points
• ____ Increased or decreased dating - 20 points
  
• ____ Changes in working conditions - 20 points
• ____ Change in your major 20 points
• ____ Change in your sleeping habits - 18 points
• ____ Several-day vacation - 15 points
• ____ Change in eating habits - 15 points
• ____ Family reunion - 15 points
• ____ Change in recreational activities - 15
  points
• ____ Minor illness or injury - 15 points
• ____ Minor violations of the law - 11 points
• Score _________________

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INTERPRETING YOUR SCORE

• Less than 150 points relatively low stress
  level in relation to life events
• 150 - 300 points borderline range
• Greater than 300 point high stress in
  relation to life events

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Interpret SRRS cautiously

• research suggests the SRRS is only a modest
  predictor of future health problems

events are not equally stressful to all
a. perception of stress is very personal and
subjective
b. stress is not the only variable affecting
susceptibility to illness
48
HOLMES RAHE focused mainly on MAJOR, fairly
dramatic life events (Ex. Death of love one)
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LAZARUS
HASSLES
Much stress arises from daily chronic or
repeated conditions of living
Ex. like a Chinese Water Torture
HASSLES petty annoyances, irritations,
frustrations, minor
disagreements.
The number and severity of daily hassles were
significantly better predictors of headaches than
were scores on the life events scale.
It was not so much the number of daily hassles
that predicted headaches, but rather the
perceived severity of the hassles.
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Major events trigger many little HASSLES
(MICROSTRESSORS) which give rise to stress
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IT IS NOT THE EVENTS THEMSELVES, but how we
appraise/perceive them that influences their
stressfulness.
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3 COMMON SOURCES OF STRESS

• 1. Frustrations

• progress toward the desired goal
• is blocked or delayed

2. Conflicts
3. Pressures

• situations that require a person to do
• too much
• in too short a time

elements of all 3 may be present in the same
situation
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4 BASIC SOURCES OF FRUSTRATION
1. DELAYS
2. LOSS/REJECTION
3. LACK OF RESOURCES
4. FAILURE
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1. FRUSTRATION

• INTENSITY OF FRUSTRATION INCREASES AS
• STRENGTH,
• URGENCY, AND
• IMPORTANCE OF BLOCKED MOTIVE INCREASES

MUST GIVE UP GOAL OR
OVERCOME OBSTACLES
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Frustration and common reactions to it.
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2. CONFLICT

• cant completely resolve a conflict
• must give up one goal
• modify one or both goals
• or delay your pursuit of one goal

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2. CONFLICT

• The longer any conflict exists
• or
• The more important the decision,
• The more stress the person will experience

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TYPES OF CONFLICTS

• APPROACH APPROACH

AVOIDANCE - AVOIDANCE
"caught between a rock and a hard place"
APPROACH - AVOIDANCE
DOUBLE APPROACH - AVOIDANCE
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Fig. 15.4 Three basic forms of conflict. For this
woman, choosing between pie and ice cream is a
minor approach-approach conflict deciding
whether to take a job that will require weekend
work is an approach-avoidance conflict and
choosing between paying higher rent and moving is
an avoidance-avoidance conflict.
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Conflict diagrams. DESIRES TO APPROACH AND TO
AVOID INCREASE NEAR A GOAL. 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.
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3. PRESSURE
EX. TIME PRESSURE REDUCES CREATIVITY
WHEN WE FEEL FORCED TO SPEED UP,
INTENSIFY,
OR SHIFT THE DIRECTION OF OUR BEHAVIOR,
OR TO MEET A HIGHER STANDARD OF PERFORMANCE
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SEVERITY OF STRESS

• DETERMINED PRIMARILY BY 3 FACTORS

SITUATION
1. CHARACTERISTICS OF THE
INDIVIDUAL
2. CHARACTERISTICS OF THE
3. EXTERNAL RESOURCES AND SUPPORT
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SEVERITY OF STRESS
1. CHARACTERISTICS OF THE
SITUATION
A. strength of conflicting forces
B. presence of a threat
C. imminence of an anticipated threat
D. unfamiliarity and suddenness of the problem
E. CONTROLABILITY
F. PREDICTABILITY
G. LEVEL OF CHALLENGE OR THREAT TO ONES
CAPABILITIES OR SELF-CONCEPT
Stress occurs in situations in which we
feel/perceive our self threatened beyond our
capacity to adapt, cope or endure
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E. CONTROLABILITY
1. CHARACTERISTICS OF THE SITUATION cont.

• stressors usually have less impact if people can
  exert some control over them.

it seems that just believing that a stressor can
be controlled can reduce the stressors effect.
FAITH
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E. CONTROLABILITY
1. CHARACTERISTICS OF THE SITUATION cont.

• Rat can press lever to turn off shock ? less
  stress

Take away the lever ? massive stress response !
Even if lever not connected still helps if rat
(or human turning off noise) THINKS it works.
YOU DONT HAVE TO FEEL IN CONTROL SO LONG AS YOU
EXPECT EVERYTHING WILL TURN OUT OK
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1. CHARACTERISTICS OF THE SITUATION cont.
E. CONTROLABILITY

• Having some control over unpleasant events
• lower stress levels than those who feel
  they have
• no control

EXAMPLES 1. RAT STUDY
2. Langer and Rodin nursing home control
MEALS TV PLANT
CHOOSE WHICH ROOM TO MEET VISITORS
1 1/2 YEARS LATER IF THEY HAD CONTROL AND
RESPONSIBILITY THEN MORE ACTIVE, SOCIABLE, FEWER
SOMATIC COMPLAINTS FEWER DEATHS.
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research with rats indicates that predictability
of stressful events (example shocks) leads to
fewer stressful reactions
1. CHARACTERISTICS OF THE SITUATION cont.
F. PREDICTABILITY
unpredictable events are more stressful vs
predictable ones
law enforcement is particular stressful because
of unpredictable nature of work
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Predictable stressors may have less impact
because they give the person time to mobilize
resources to cope with the stressors.
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Irving Janus - giving surgical patients
information about what will happen during
surgical procedures, the pain or disability they
can expect after procedures, and ways to reduce
pain or overcome disability greatly improves
their adjustment to surgery.
F. PREDICTABILITY
Stress Inoculation
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Stress Inoculation
F. PREDICTABILITY
Patients given information to prepare them for
surgery experienced less distress before and
after surgery, were able to leave the hospital
sooner, required less medication, and
experienced less pain than patients not given
the information.
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Pre-operative information appears to give
patients a sense that they can control certain
aspects of their experience -- for example, by
engaging in breathing exercises to reduce their
pain -- and a sense that, even if they cannot
control what will happen to them, what will
happen is somewhat predictable..
F. PREDICTABILITY
Ex. LAMAZE CHILDBIRTH
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Another reason predictable aversive events may be
less stressful is that with predictable events,
people know they can relax until they get the
warning that the events are about to occur.
With unpredictable events, people feel they can
never relax because the events may occur at any
time. Thus, they remained anxious all the time
F. PREDICTABILITY
73
Some people can handle stress and some cannot.
SEVERITY OF STRESS - 3 factors

SITUATION
1. CHARACTERISTICS OF THE
2. CHARACTERISTICS OF THE

INDIVIDUAL

• Some INDIVIDUAL DIFFERENCES that are responsible
  for this

AGE
Intellectual Motivational Personality Beliefs
HEALTH
DEGREE OF COMPETENCE
DIET
INCOME
STRESS TOLERANCE
SOCIAL STATUS
PREVIOUS EXPERIENCE
OPTIMISM/PESSIMISM
STRESS CAN BE SELF-IMPOSED
3.
TERNAL RESOURCES AND SUPPORT
EX
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ADAPTATION TO STRESS CAN BE COSTLY

• 1. LOWERING OF ADAPTIVE EFFICIENCY

• IMPAIRED DECISION MAKING

• IMPAIRED PROBLEM SOLVING

• DIFFICULTY SEEING ALTERNATIVES

2. LOWERING OF RESISTENCE TO OTHER STRESSES
3. CAUSE WEAR AND TEAR ON THE PERSON
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GENERAL ADAPTATION SYNDROME (GAS)

• HANS SELYE

3 STAGES

• 1. ALARM STAGE

2. RESISTANCE STAGE
3. EXHAUSTION STAGE
76
General Adaptation Syndrome (GAS) Hans Selye
Series of bodily reactions to prolonged stress
occurs in 3 stages
MOBILIZATION STAGE BECOME AWARE OF
STRESSOR Body resources are mobilized to cope
with added stress
1. ALARM

FIGHT OR FLIGHT
2. RESISTANCE

• Arousal high
• as body tries to defend and adapt to stressor

Body adjusts to stress but at a high physical
cost resistance to other stressors is lowered
Bodys resources are drained and stress hormones
are depleted, possibly resulting in psychosomatic
disease, loss of health, or complete collapse
(death)
3. EXHAUSTION
Little physical resources little resistance to
disease
NEGATIVE CONSEQUENCES OF STRESSOR APPEAR
77
Why Do People Develop a Psychological Stress
Disorder?

• Clearly, extraordinary trauma can cause a stress
  disorder
• To understand why only some people develop stress
  disorders, researchers have looked to the
  survivors biological processes, personalities,
  childhood experiences, and social support
  systems,
• and to the severity of the trauma itself.

78
Diathesis-Stress Model
79
BURNOUT (BONUS)

• A STATE OF PHYSICAL AND EMOTIONAL EXHAUSTION

IT INCLUDES FEELINGS OF 1.
2.
3.
HOPELESSNESS
CHRONIC FATIGUE
LOW ENERGY
BURNOUT USUALLY OCCURS BECAUSE OF A
ACCUMULATION OF
EVERYDAY STRESSES.
GRADUAL
Burnout is brought about by sustained stress
without adequate adjustment.
BURNOUT A COMMON REASON FOR STUDENTS LEAVING
SCHOOL BEFORE EARNING THEIR DEGREES.
80
What is Burnout?

• BURNOUT INVOLVES A GRADUALLY INTENSIFYING PATTERN
  OF
• PHYSICAL, EMOTIONAL OR SPIRITUAL EXHAUSTION
• IN RESPONSE TO STRESSORS THAT CONTINUE DAY AFTER
  DAY
• BURNOUT IS OTHERWISE KNOWN AS EXHAUSTION OR WHEN
  THE BODILY RESERVES USED IN THE STRESS RESPONSE
  HAVE BEEN USED UP.

81
BURNOUT IS CHARACTERIZED BY
A. PHYSICAL EXHAUSTION

FEEL FATIGUED, TENSE, USED-UP, LOW ENERGY
INCREASED PHYSICAL COMPLAINTS HEADACHES,
UPSET STOMACH
B. PSYCHOLOGICAL EXHAUSTION

FEEL APATHETIC, I DONT GIVE A DAMN
ANYMORE DEPRESSION, HOPELESSNESS,
HELPLESSNESS FEEL TRAPPED - IN JOB,
MARRIAGE, ETC. DEVELOP NEGATIVE
ATTITUDES TOWARD OTHERS, THEMSELVES,
THE FUTURE, AND LIFE IN GENERAL
FEELING OF REDUCED PERSONAL ACCOMPLISHMENT
C. BEHAVIORAL CHANGES
DEPERSONALIZATION- DETACHMENT FROM OTHERS,
ESPECIALLY THOSE YOU WORK WITH
DEPERSONALIZATION IS identified by the
treatment of others as
objects rather than people. PERFORMANCE
DETERIORATES
82
Who Suffers From Burnout

• Anyone can suffer from burnout.
• It is not a sign of weakness, mental illness or
  inability to cope with life.
• Burnout can be treated, overcome, and prevented
  in the future.

83
BURNOUT IS A PROBLEM IN EMOTIONALLY DEMANDING
PROFESSIONS - EX. NURSES, PHYSICIANS,
PSYCHOLOGISTS, SOCIAL WORKERS,
TEACHERS, PARENTS
BURNOUT IS ALSO COMMON IN JOBS WHERE LITTLE
POSITIVE FEEDBACK OR APPRECIATION IS PRESENT.
WHERE YOUR EFFORTS ARE USELESS,
INEFFECTIVE, OR UNAPPRECIATED.
84
What to Do?

• Know Yourself
• Know your limitations
• Gage your reactions, learn to take each day one
  step at a time
• Become a Stress Expert, know about Stress and
  how it affects your mind and body.
• Dont do nothing, if you think you are getting
  burned out and have the symptoms speak to someone
  about it!

85

• SOLUTIONS

REDESIGN WORK REQUIREMENTS

• REDUCE WORKLOAD

• DEVELOP HOBBIES OUTSIDE INTERESTS

• BUILD A SUPPORT SYSTEM

• PEOPLE WITH GOOD SUPPORT SYSTEMS AND SATISFYING
  LIVES OUTSIDE WORK (EX. A STABLE LOVE
  RELATIONSHIP), ARE LESS LIKELY TO EXPERIENCE
  BURNOUT

86
Stress, Coping, and the Anxiety Response

• Stress reactions are often at play in
  psychological disorders
• People who experience a large number of stressful
  events are particularly vulnerable to the onset
  of GAD, social phobia, panic disorder, and OCD,
  as well as other psychological problems

Ex. Acute stress disorder Posttraumatic
stress disorder
87
The Psychological Stress Disorders

• During and immediately after trauma, many people
  become highly anxious and depressed
• For some, feelings persist well after the trauma
• These people may be experiencing

Acute stress disorder Posttraumatic stress
disorder (PTSD)
The precipitating event usually involves actual
or threatened serious injury to self or others
88
The Psychological Stress Disorders (Bonus)

• Acute stress disorder
• Symptoms begin within four weeks of event and
• last less than one month
• Posttraumatic stress disorder (PTSD)
• Symptoms can begin at any time following the
  event but must last for longer than one month
• May develop from acute stress disorder

89
POST-TRAUMATIC STRESS DISORDER (Bonus)
most common feature re-experience original
trauma in nightmares or vivid memories

• Symptoms may appear immediately, or weeks,
  months, even years after the traumatic event

• in rare cases, disturbing waking recollections
• known as may
  occur

flashbacks
90
Post traumatic stress disorder (PTSD) SYMPTOMS
(Bonus)

• recurring bouts of anxiety, irritability,
  jumpiness, anger,
• inability to concentrate, feeling overwhelmed ,
• Loss of interest, crying uncontrollably,
  headaches
• Isolating oneself, difficulty interacting
  socially ,
• dizziness, intestinal problems sleep
  problems, nightmares, sexual dysfunction,
• DRUG ALCOHOL ABUSE
• Feeling guilty about surviving the event or not
  being able to solve the problem, change the
  event, or prevent the disaster

emotional numbness, guilt and depression
91
Recovery takes time. Some people may require
professional help, but all need the support of
family and friends.
PTSD (Bonus)
92
PSYCHOLOGICAL ASPECTS OF CANCER
93
Coping with Stress
Problem-Focused Coping

• Attempts to modify the source of stress.
• Problem-focused strategies lead to changes in
  behavior or to the development of a plan of
  action to deal with stress.

USED WHEN you THINK CHANGE IS POSSIBLE
Emotion-Focused Coping
People consciously attempt to manage their
emotions in the face of stress, seeking to change
the way they feel about or perceive a
problem.Includes strategies such as accepting
sympathy from others and looking at the bright
side of a situation.
USED WHEN THINK IT IS NOT POSSIBLE TO CHANGE THE
SITUATION
94
Coping With Stress

• Problem-Focused Coping Direct coping
• Intentional efforts to change an uncomfortable
  situation
• Confrontation
• Acknowledging stress directly and initiating a
  solution
• Compromise
• Choosing a more realistic goal when an ideal goal
  cannot be met
• Withdrawal
• Avoiding a situation when other options are not
  practical

95
Problem-Focused Coping

• Planful Problem-Solving analyzing the situation
  to arrive at solutions and then taking direct
  action to correct the problem.
• Confrontive Coping taking assertive action,
  often involving anger or risk taking to change
  the situation.

96
Problem-Focused Coping

• Aimed at reducing the demands of the situation or
  expanding the resources for dealing with it.
• Often used when the person believes that the
  demand is changeable.

97
Emotion-Focused Coping

• Aimed at controlling the emotional response to
  the stressor.
• Behavioral (use of drugs, alcohol, social
  support, distraction) and
• cognitive (change the meaning of the stress).
• Often used when the person feels he/she cant
  change the stressor (e.g., bereavement) or
• Doesnt have resources to deal with the demand.

98
Emotion-Focused Coping

• Seeking social support can be either problem or
  emotion-focused coping.
• Distancing cognitive effort to detach
• Escape-avoidance wishful thinking or taking
  action to escape or avoid it.
• Self-control attempting to modulate ones
  feelings in response to the stressor.
• Accepting responsibility acknowledging ones
  role in the situation while trying to put things
  right.
• Positive reappraisal create positive meaning.

99
Effects of Culture on Coping

• Many factors, including gender roles and culture,
  influence our tendency to favor one coping
  strategy over another.
• Men are more likely to use problem-focused coping
  as the first strategy when they confront a
  stressor
• Women, who tend to have larger support networks
  and higher needs for affiliation than men, are
  more likely than men to seek social support
• Women are also more likely to use emotion-focused
  coping

100
How to manage Stress?
ANY 6 WAYS

• Identify the source.
• Make choices that control stress.
• Coping and relaxing to prevent stress buildup.
• Practice good health habits.
• Plan and Manage your time

101
Stress Management

• Laughter has been shown to lower blood pressure,
  and it triggers the release of endorphins, which
  results in a sense of well-being.
• Re-channeling your energy
• Relaxing exercise in peaceful surroundings.
• People SupportFriends, Family, Church, Teachers
• Express yourself - talk it over with family,
• friends, counselors, clergy.
• Community involvement

• Minimize time spent with people who contribute to
  your psychological distress.
• Seek out people who contribute to your
  psychological health.

102

• Stress Management Strategies continued...

• Incorporate humor into your life.
• Listen to music.
• Put some energy into your appearance, your dress,
  hairstyle, or skin.
• Decrease negative thinking increase positive
  thinking.
• Monitor your anger level--strive to reduce your
  anger if necessary.
• Animals can help

• Sit quietly for a few minutes each day.
• Select a lifestyle that fits your psychological
  needs.

Be patient
with yourself and
others. Tempers are short
in times of crisis, and others may be
feeling as much stress as you
are.
103
Methods of Reducing Stress

• Learn to cope effectively
• Proactive coping
• Anticipate stressful events and take steps to
  avoid them
• Positive reappraisal
• Alter the way you think about a stressful
  situation
• Making the best of a tense or stressful event
• Humor
• Finding the funny things in a situation

104
Adopt a Healthy Lifestyle

• Maintain regular and consistent sleep patterns.
  Get enough sleep to wake up refreshed.

• Eat a well-balanced diet
• Exercise
• Quit smoking
• Avoid high risk behaviors

• select a healthful diet use less salt, refined
  carbohydrates, sugar, and caffeine. Reduce
  caffeine (2 1/2 cups of coffee doubles your
  epinephrine level).
• eat vegetables, fruits, complex carbohydrates,
  and vitamins.

105
Coping With Stress at College

• Plan ahead
• Prioritize
• Exercise
• Listen to music, watch TV, or go out as a study
  break
• Talk to others
• Meditate or use other relaxation techniques

106
Signs of Time Management Problems-

• Always rushing
• Constantly miss deadlines
• Have trouble finding things
• Are overwhelmed by demands and details
• Try to do several tasks at once
• Cant decide what to do next

107
Time Management

• Set short-term (e.g., daily) and long-term (e.g.,
  yearly) goals.
• Make daily to-do lists (prioritize each).
• Make a daily schedule for when and where you will
  carry out your to-do list items (estimate time
  allocated for each to-do item).
• Revise throughout the day as needed.

108
Methods of Reducing Stress

• Calm down
• Exercise
• Relaxation training
• Reach out
• Social support network
• Religion
• Studies have shown an association between
  religion and lower stress
• May be related to social support
• Altruism
• Giving to others because it gives you pleasure
• Shown to be a good way to reduce stress

109
THINGS YOU CAN DO AT WORK

• BE GOAL ORIENTED, BUT BE FLEXIBLE -
• YOUR WAY IS NOT THE ONLY WAY
• APPROPRIATE WORKPLACE INTERACTIONS - FRIENDS
• REDUCE STRESS
• ENEMIES ENHANCE STRESS,
• DONT GOSSIP
• ESTABLISH A ROUTINE MAINTAIN A SENSE OF HUMOR
• COMMUNICATE - WITH EVERYONE - SUPERVISOR,
• PEER, SUBORDINATE

110

• Stress Management Strategies continued...

• Therapeutic massage.
• Deep muscle relaxation.
• Transcendental meditation may decrease your heart
  rate, lower your blood pressure, and reduce your
  oxygen consumption. It is considered a natural
  antidote to tension.
• YOGA, TAI CHI, PROGRESSIVE RELAXATION, MEDITATION
• Self-hypnosis
• Rhythmic breathing--deep, slow, relaxed breathing

• Biofeedback techniques can help up to 80 of
  migraine headache sufferers. Acupuncture can
  also be effective.
• Prayer and religious commitment.
• Develop your potential and special interests
  sports, literature, music, dance, languages,
  technical skills, crafts.
• Vacations, mini-vacations, or mind vacations
  (where you sit quietly, close your eyes, and go
  to the mountains or seaside).
• Balance work and recreation.

11
111

• Stress Management Strategies continued...

• Be aware of natural surroundings, observe nature,
  
• Decorate to de-stress your home.
• Limit large blocks of red or yellow.
• Visual clutter can lead to mental
  clutter.
• Use anti-anxiety medication - if appropriate.
• Identify goals and work toward them.

• Learn to be proactive, not reactive.
• Stop procrastinating.
• Learn positive problem-solving techniques
• delay gratification
• take one step at a time--break big problems
• into smaller component parts.
• Take direct action to address stressful
  situations.

13
PLAN/ORGANIZE/DELEGATE
- SPOUSE, KIDS, FRIENDS
112
III. STRESS-MATH

• Caffeine and tobacco raise
• heart rate 14 beats per minute.

When combined with stress, the heart rate is
increased to 38 beats a minute.
A smokers heart beats____________ more times in
a twenty four period.
20,160
113
IV. STRESS-MATH

• Caffeine and Smoking raises heart rate 14 beats
  per minute.

When combined with stress, the heart rate is
increased to 38 beats a minute.
If you are a smoker, under stress, your heart
beats____________ more times in a twenty-four
hour period.
54,720
114
The end
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116
subjects shown vivid photographs of victims of
island deaths experimental group could terminate
their viewing by pressing a button control
group could not
117
both groups of subjects saw the same photographs
for the same duration of time.
The level of anxiety for both groups was
measured .
118
The experimental group showed much less anxiety
while viewing the photographs than did the
control group, even though the only difference
between the groups was their control over their
viewing
119
People who think they have NO CONTROL over
stressors often develop feelings of helplessness
and hopelessness. These feelings may promote
depression or other mental disorders or
vulnerability to physical disease.
120
unpredictable events studies shocks or noise
preceded by warning tone and therefore
predictable less stressful vs. Shocks or noise
preceded by no warning tone.
121
Research also suggests that if mild predictable
stresses continue over a long time, they can be
more damaging than unpredictable ones
122
Not so fast!

• Which factor is more important?
• Winning lottery (things getting better) is
  usually good (even though unpredictable).
• Some people persist in known misery rather than
  try to change for the good.
• Some lack of control/predictability can be good
• Roller coaster ride, mystery novel, random act of
  kindness.
• Boring job can be a drudge.

123
Cognitive Therapy Albert Ellis, Aaron Beck

• Assumes that stress arises or is augmented by
  faulty or irrational ways of thinking.
• Catastrophizing It is awful if I get turned
  down when I ask for a date.
• Overgeneralizing I didnt get a good grade on
  this test. I cant get anything right.
• Selective abstraction Only seeing specific
  details of the situation (e.g., Seeing the
  negatives but missing the positive details).

124
Cognitive Therapy

• Errors in Information Processing -
• Irrational Thinking Errors include
• Emotional reasoning
• Overgeneralization
• Catastrophic thinking
• Mind reading
• Selective negative focus, etc.

125
Time Management

• Set short-term (e.g., daily) and long-term (e.g.,
  yearly) goals.
• Make daily to-do lists (prioritize each).
• Make a daily schedule for when and where you will
  carry out your to-do list items (estimate time
  allocated for each to-do item).
• Revise throughout the day as needed.

126
A perception of things worsening

• Rats
• 50 or 10 shocks on day 1
• 25 shocks on day 2
• Rats with the increase on day 2 had greater
  stress R.

127
Subtleties of predictability

• How predictable is the stressor in absence of
  warning?
• Warning less effective for either very rare or
  very common stressors.
• How far in advance is the warning?
• Not helpful either immediately before or too long
  before stressor.
• How specific is the warning?
• Orange alert

128
Subtleties of control

• If you think you have control, but dont, you may
  feel guilt if stressor occurs.
• Blaming others for what happens to them.
• Woman wearing suggestive clothes
• Minorities not assimilating

129
Summary

• Both physical and psychological stressors can ?
  stress response.
• Outlets for frustration reduce stress R.
• Social support networks do, too.
• Predictability may help, if not too far ahead of
  stressor or too close.
• Control helps, within limits.
• Perception of things getting better helps.

130
What Triggers a Psychological Stress Disorder?

• Victimization and stress disorders
• People who have been abused or victimized often
  experience lingering stress symptoms
• Psychological impact is immediate and may be
  long-lasting
• One study found that 94 of rape survivors
  developed an acute stress disorder within 12 days
  after assault

Ongoing victimization and abuse in the family may
also lead to stress disorders
131
Post-Traumatic Stress Disorder

• Families of those who suffer extreme traumatic
  stress can also develop Post-Traumatic Stress
  Disorder. (U.S. Surgeon Generals Report, 1999).
• Approximately 9 of those exposed to extreme
  trauma develop Post-Traumatic Stress Disorder.
  (U.S. Surgeon Generals Report, 1999)
• Approximately 15 of Vietnam veterans are
  suffering from Post-Traumatic Stress Disorder 19
  years after combat exposure (U.S. Surgeon
  Generals Report, 1999)
• Women who are victims of crime, and torture and
  concentration camp survivors suffer the highest
  rates of Post-Traumatic Stress Disorder (U.S.
  Surgeon Generals Report, 1999)
• Approximately 50 of Post-Traumatic Stress
  Disorder cases remit within one year (U.S.
  Surgeon Generals Report, 1999)
• An estimated 8 of those who served in the
  Persian Gulf War in 1991 have developed
  Post-Traumatic Stress Disorder (National
  Institutes of Mental Health)
• Approximately 30 of those who have spent time in
  war zones experience Post-Traumatic Stress
  Disorder. (National Institutes of Mental Health)

132
Biopsychosocial Aspect of Stress

• How stress affects health
• Via behaviour
• Via physiology

133
Behavioural Aspects

• Increased alcohol
• Smoking
• Increased caffeine
• Poor diet
• Inattention leading to carelessness

134
Physiological Aspects

• Cardiovascular reactivity increased blood
  pressure, platelets, lipids (cholesterol)
• Endocrine reactivity increased catecholamines
  and corticosteroids
• Immune reactivity increased hormones impairs
  immune function

135
Psychophysiological Disorders

• Digestive system e.g., ulcers, irritable bowel
  syndrome
• Respiratory system e.g., asthma
• Cardiovascular system e.g., hypertension, lipid
  disorders, heart attack, angina

136
Coping responses respond yes or no.

1. Tried to see the positive side of it.
2. Tried to step back from the situation and be more
   objective.
3. Prayed for guidance or strength.
4. Sometimes took it out on others when I felt angry
   and depressed.
5. Got busy with other things to keep my mind off
   the problem.
6. Read relevant material for solutions and
   considered several alternatives.
7. Took some action to improve the situation.

137
Life Orientation Test(Scheier Carver)

• In uncertain times, I usually expect the best.
• If something can go wrong for me it will.
• I always look on the bright side.
• Im always optimistic about my future.
• I hardly ever expect things to go my way.
• Things never work out the way I want them to.
• Im a believer in the idea that every cloud has
  a silver lining.
• I rarely count on good things happening to me.
• Overall, I expect more good things to happen to
  me than bad.

138
Social Support

• Emotional support expression of empathy,
• understanding, caring, etc.
• Esteem support positive regard,
• encouragement, validating
  self-worth
• Tangible or instrumental lending a helpful
• hand.
• Information support providing information,
• new insights, advice.
• Network support feeling of belonging

139
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