Health, Stress, and Coping Chapter 15
Health, stress, and coping • What is stress? • The stress-illness mystery • The physiology of stress • The psychology of stress • Coping with stress
What is Stress? • Stress is subjective; can include: • sudden traumatic experiences • continuing pressures that seem uncontrollable • small irritations that wear you down • Holmes and Rahe developed the Social Readjustment Rating Scale (SRRS) • a stress scale that rates the degree to which life events are stressful
Daily Hassles • SRRS considers both positive and negative events as stressful. • Most stress, however, comes from a series of little stressors, or daily hassles, that include irritations and demands that occur in daily life. • Stress reactions to hassles may predict one’s stress toward major life events.
The Stress-Illness Mystery • Stressors can increase illness when they: • severely disrupt a person’s life • are uncontrollable • are chronic (i.e., lasting at least 6 months)
Stressors and the Body • Noise • Bereavement and Loss • Work-Related Problems • Poverty and Powerlessness • Recent Immigration
The Physiology of Stress • General adaptation syndrome. (Selye’s Theory) • There are three phases in responding to stressors: • Alarm • Resistance • Exhaustion • Goal is to minimize wear and tear on the system.
Current Approaches • HPA (Hypothalamus-pituitary-adrenal cortex axis) • A system activated to energize the body to respond to stressors. • The hypothalamus sends chemical messengers to the pituitary gland. • The pituitary gland prompts the adrenal cortex to produce cortisol and other hormones.
The Mind-Body Link • Psychoneuroimmunology (PNI) • The study of the relationships among psychology, the nervous and endocrine systems and the immune system. • Psychological factors explain why not all people are stressed the same amount by the same things.
The Psychology of Stress • Emotions and illness • Letting grievances go • Explanatory styles • The sense of control • The benefits of control • The limits of control
Emotions and Illness • Hostility and heart disease. • Type A Personality: Determined to achieve, sense of time urgency, irritable, respond to threat or challenge very quickly, and impatient with obstacles. • Type B Personality: Calmer and less intense. • Personality type is less predictive of health problems than is hostility. • Proneness to anger is a major risk factor.
Hostility and Heart Disease • Men with highest hostility scores as young medical students had higher rates of heart disease 25 years later. • Hostility is more hazardous than a heavy workload.
Depression and Disease • Two studies followed 1000 people for many years. • Those who had been clinically depressed at the outset were 2-4X more likely to have a heart attack than nondepressed people were. • Other research failed to find the link.
Emotional Inhibition • Emotional Inhibition: A personality trait involving a tendency to deny feelings of anger, anxiety, or fear; in stressful situations, physiological responses such as heart rate and blood pressure rise sharply. • People who display this trait are at greater risk of becoming ill than people who can acknowledge feelings.
Letting Grievances Go • Research on confession: divulging private thoughts and feelings that make you ashamed or depressed. • First-year students who wrote about their fears reported greater short term homesickness and anxiety. By end of year they had fewer bouts of flu and visits to the infirmary. • Can also give up thoughts that produce grudges and replace them with different perspectives. • Forgiving thoughts.
Explanatory Styles • 2 styles: optimistic and pessimistic explanatory style • Optimism seems to produce good health and even prolong life. • Pessimism is associated with early death. • Optimists take better care of themselves when they get sick, cope better, and draw on social support. • Pessimists often engage in self-destructive behaviours.
The Sense of Control • Locus of Control • A general expectation about whether the results of your actions are under your own control (internal locus) or beyond your control (external locus). • Feelings of control can reduce or even eliminate the relationship between stressors and health.
The Benefits of Control • Among people exposed to cold viruses, those who feel in control of their lives are 1/2 as likely to develop colds. • Low-income people with a strong sense of control are as healthy as people from higher-income groups. • People with more control over their work pace and activities have fewer illnesses and stress symptoms. • Residents of nursing homes show more alertness, happiness, and longevity when given more choices and control over their activities.
The Limits of Control • Primary Control (Western Cultures) • An effort to modify reality by changing other people, the situation, or events; a “fighting back” philosophy. • Secondary Control (Eastern Cultures) • An effort to accept reality by changing your own attitudes, goals, or emotions; a “learn to live with it” philosophy.
Coping with Stress • Cooling Off • Solving the problem • Drawing on social support
Cooling Off • Relaxation Training • Learning to alternately tense and relax muscles, lie or sit quietly, or meditate by clearing the mind; has beneficial effects by lowering stress hormones and enhancing immune function. • Massage therapy • Exercise is also an excellent stress reliever
Fitness and Health • Among those with low stress, fit and less-fit people had similar levels of health problems. • Among those with high stress, there were fewer health problems among people who were more fit.
Solving the Problem • Emotion-focused and problem-focused coping. • Effective Cognitive Coping Methods: • Reappraising the situation • Learning from the experience • Making social comparisons • Cultivating a sense of humor
Drawing On Social Support • Friends can help with coping: • People with network of close connections live longer than those who do not. • After heart attack, those with no close contacts were twice as likely to die. • Relationships can also cause stress. • Giving support to others can be a valuable source of comfort.