Chapter 18
Psychology and Physical
Health
Models for the Effects of Psychological
Factors on Disease
Direct Effects Model
Interactive Model
Indirect Effects Model
Chapter 18
Copyright © 2004 by The McGraw-Hill Companies, Inc. All rights reserved.
a. Direct effects model
Psychological
factors (stress,
personality styles)
Psychological
changes
Disease
Physiological
changes
Disease
b. Interactive model
Psychological
factors
x
Vulnerability
to disease
c. Indirect effects model
Psychological
factors
Chapter 18
Health-related
behaviors
(smoking, sleep)
Disease
Copyright © 2004 by The McGraw-Hill Companies, Inc. All rights reserved.
Stress and Illness
Hans Selye developed
the concept of stress
as the nonspecific
response of the body
to demands to adjust
to a wide range of
changes.
Chapter 18
Copyright © 2004 by The McGraw-Hill Companies, Inc. All rights reserved.
Stress and Illness
Stressors are
demands that give rise
to the general
adaptation syndrome
(GAS), which consists
of three stages: alarm,
resistance, and
exhaustion.
Chapter 18
Copyright © 2004 by The McGraw-Hill Companies, Inc. All rights reserved.
Stress and Illness
Among the circumstances that could lead
to stress are catastrophes, major life
changes such as divorce, acculturative
stress, traumatic events such as
criminal victimization, and hassles.
They have been associated with
physiological responses such as
increased levels of stress hormones,
Chapter 18
Copyright © 2004 by The McGraw-Hill Companies, Inc. All rights reserved.
Stress and Illness
Researchers found that high levels of life
change were associated with Illness.
Subsequent Investigation showed that the
relation between major life events and
illness is not as strong as originally
reported.
One explanation is that a person's
interpretation of events is an important
determinant of the event's impact.
Chapter 18
Copyright © 2004 by The McGraw-Hill Companies, Inc. All rights reserved.
Stress and Illness
Everyday minor annoyances (hassles)
can accumulate and become associated
with subsequent health problems.
Chapter 18
Copyright © 2004 by The McGraw-Hill Companies, Inc. All rights reserved.
Stress and Illness
Interpretation or appraisal of an event
often determines whether that event is
stressful.
Chapter 18
Copyright © 2004 by The McGraw-Hill Companies, Inc. All rights reserved.
Stress and Illness
Primary appraisal
occurs when we
determine whether an
event is a threat
Secondary appraisal
occurs when we
decide how to deal
with the threat.
Chapter 18
Copyright © 2004 by The McGraw-Hill Companies, Inc. All rights reserved.
Chapter 18
Copyright © 2004 by The McGraw-Hill Companies, Inc. All rights reserved.
Characteristics of Stressful Events
Uncontrollable
Natural disasters, and many illnesses
Unpredictable
Earthquakes, some job layoffs, accidents
Challenge capabilities or self concepts
Exams, new relationships, a tough new job
Chapter 18
Copyright © 2004 by The McGraw-Hill Companies, Inc. All rights reserved.
Chapter 18
Copyright © 2004 by The McGraw-Hill Companies, Inc. All rights reserved.
Stress and Physical Health Problems
Ulcers
Asthma
Headaches
Coronary Heart Disease
Hypertension
Immunocompetence
Chapter 18
Copyright © 2004 by The McGraw-Hill Companies, Inc. All rights reserved.
Factors the Influence Reactions to
Stress
I. The Stressor Itself
Importance
Duration
Cumulative effect
Imminence
Anticipated vs. Unanticipated
Chapter 18
Copyright © 2004 by The McGraw-Hill Companies, Inc. All rights reserved.
Factors the Influence Reactions to
Stress
2. The Individual
Perception of threat
Presence of a plan
Voluntary vs. involuntary
Control and predictability
Stress tolerance (EA on Rorschach)
Chapter 18
Copyright © 2004 by The McGraw-Hill Companies, Inc. All rights reserved.
Factors the Influence Reactions to
Stress
3. External Resources & Social Support
Positive social and family relationships
Cultural rituals (funerals, confession,
atonement)
Chapter 18
Copyright © 2004 by The McGraw-Hill Companies, Inc. All rights reserved.
Coping with Stress
Ineffective Coping Strategies
Withdrawal (avoidance)
Aggression
Overreliance on primitive defense
mechanisms (distort reality)
Chapter 18
Copyright © 2004 by The McGraw-Hill Companies, Inc. All rights reserved.
Coping with Stress
Effective Coping Strategies
Removing stressors
Cognitive coping – changing the way we
think about an event
Managing stress reactions – sometimes, if
we can’t change the reality, we have to
deal with the response
schedule relaxing activities
 relaxation training

Chapter 18
Copyright © 2004 by The McGraw-Hill Companies, Inc. All rights reserved.
Coping Strategies
Repressive coping: being unable to admit to
negative emotions; lacking an awareness of
one’s negative emotions
John Henryism: Constantly battling against
obstacles that may be insurmountable
Seeking social support: Seeking others who
will provide positive emotional and practical
support in times of stress
Finding meaning or benefit: Searching for
some positive meaning or benefit derived from
stressful situations
Chapter 18
Copyright © 2004 by The McGraw-Hill Companies, Inc. All rights reserved.
Chapter 18
Copyright © 2004 by The McGraw-Hill Companies, Inc. All rights reserved.
Behavioral and Cognitive Interventions
Intervention
Description
Guided mastery
techniques
Provide explicit information on how to engage in
positive behaviors and opportunities to practice
these behaviors in challenging situations.
Reduction of
catastrophizing
cognitions
Provide basic education about illness to reduce
concern; help the person engage in positive
coping.
Biofeedback
Helps the person identify signs that bodily
processes are going awry, and ways of controlling
them, often through relaxation.
Time management
Teach the person to reduce obligations, prioritize
and schedule important activities, break tasks up,
reward self.
Chapter 18
Copyright © 2004 by The McGraw-Hill Companies, Inc. All rights reserved.