Chapter 15
Health, Stress, and Coping
Table of Contents
Exit
Health Psychology and
Behavioral Risk Factors
Health Psychology: Uses behavioral
principles to prevent illness and
promote health
Behavioral Medicine: Applies
psychology to manage medical
problems e.g., asthma and diabetes
Lifestyle Diseases: Diseases related to
health-damaging personal habits
Table of Contents
Exit
Health Psychology and
Behavioral Risk Factors (cont.)
Behavioral Risk Factors: Behaviors that
increase the chances of disease, injury,
or premature death
Disease-Prone Personality: Personality
type associated with poor health;
person tends to be chronically
depressed, anxious, hostile, and
frequently ill
Table of Contents
Exit
Ways to Promote Health and
Early Prevention
Refusal Skills Training: Program that teaches
young people how to resist pressures to
begin smoking
Life Skills Training: Teaches stress reduction,
self-protection, decision making, self-control,
and social skills
Role Model: Person who serves as a positive
example of good and desirable behavior
Wellness: Positive state of good health and
well-being
Table of Contents
Exit
Fig. 15.1 The nine leading causes of death in the United States are shown in this graph. As you can see,
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. (Data from McGinnis & Foege, 1993.)
Table of Contents
Exit
Table 15.2 – Major healthpromoting behaviors
Table of Contents
Exit
Stress
Mental and physical condition that occurs
when a person must adjust or adapt to the
environment

Includes marital and financial problems
Stress Reaction: Physical reaction to stress

Autonomic Nervous System is aroused
Stressor: Condition or event that challenges
or threatens the person
Pressure: When a person must meet urgent
external demands or expectations
Table of Contents
Exit
Fig. 15.2. Stress is the product of an interchange between a person and the environment.
Table of Contents
Exit
CNN - Shrinking Brains
Table of Contents
Exit
Burnout
Burnout: Job-related condition (usually
in helping professions) of physical,
mental, and emotional exhaustion
Emotional Exhaustion: Feel “used up” and
apathetic toward work
 Cynicism: Detachment from the job
 Feeling of reduced personal
accomplishment

Table of Contents
Exit
Appraising Stressors
Threat: Event or situation perceived as
potentially harmful
Primary Appraisal: Deciding if a situation is
relevant or irrelevant, positive or threatening
Secondary Appraisal: Assess resources and
decide how to cope with a threat or challenge
Perceived lack of control is just as threatening
as an actual lack of control
Table of Contents
Exit
Threats and Frustration
Problem-Focused Coping: Managing or
altering the distressing situation
Emotion-Focused Coping: Trying to control
one’s emotional reactions to the situation
Frustration: Negative emotional state that
occurs when one is prevented from reaching
desired goals


External Frustration: Based on external conditions
that impede progress toward a goal
Personal Frustration: Caused by personal
characteristics that impede progress toward a goal
Table of Contents
Exit
Reactions to Frustration
Aggression: Any response made with the
intention of harming a person, animal, or
object
Displaced Aggression: Redirecting
aggression to a target other than the source
of one’s frustration
Scapegoating: Blaming a person or group for
conditions they did not create; the scapegoat
is a habitual target of displaced aggression
Table of Contents
Exit
Reactions to Frustration (cont.)
Escape: May mean actually leaving a
source of frustration (dropping out of
school) or psychologically escaping
(apathy)
Conflict: Stressful condition that occurs
when a person must choose between
contradictory needs, desires, motives,
or demands
Table of Contents
Exit
Fig. 15.3 Frustration and common
reactions to it.
Table of Contents
Exit
Conflicts
Approach-Approach Conflicts: Having to
choose between two desirable or positive
alternatives (e.g., choosing between a new
BMW or Mercedes)
Avoidance-Avoidance Conflicts: Being forced
to choose between two negative or
undesirable alternatives (e.g., choosing
between going to the doctor or contracting
cancer)

NOT choosing may be impossible or undesirable
Table of Contents
Exit
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 approachavoidance conflict; and choosing between paying higher rent and moving is an avoidance-avoidance
conflict.
Table of Contents
Exit
Fig. 15.5 Conflict diagrams. As shown by the colored areas in the graphs, desires to approach and to
avoid increase near a goal. The effects of these tendencies are depicted below each graph. 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. Again,
these tendencies are depicted (below) by the action of the ball. (Graphs after Miller, 1944.)
Table of Contents
Exit
Conflicts (cont.)
Approach-Avoidance Conflicts: Being
attracted (drawn to) and repelled by the
same goal or activity; attraction keeps
person in the situation, but negative
aspects can cause distress
Ambivalence: Mixed positive and
negative feelings; central characteristic
of approach-avoidance conflicts
Table of Contents
Exit
Multiple Conflicts
Double Approach-Avoidance Conflicts: Each
alternative has both positive and negative
qualities
Vacillation: When one is attracted to both
choices; seeing the positives and negatives
of both choices and going “back and forth”
before deciding, if deciding at all!
Multiple Approach-Avoidance Conflicts: When
several alternatives have positive and
negative features
Table of Contents
Exit
Anxiety
Feelings of tension, uneasiness,
apprehension, worry, and vulnerability

We are motivated to avoid experiencing
anxiety
Table of Contents
Exit
Freudian Defense Mechanisms;
Psychological Defenders of You!
Defense Mechanisms: Habitual and unconscious (in
most cases) mental processes designed to reduce
anxiety





Work by avoiding, denying, or distorting sources of threat or
anxiety
If used short term, can help us get through everyday
situations
If used long term, we may end up not living in reality
Most operate unconsciously
Protect idealized self-image so we can live with ourselves
Table of Contents
Exit
Freudian Defense Mechanisms:
Some Examples
Denial: Most primitive; refusing to accept or
believe reality; usually occurs with death and
illness
Repression: When painful memories,
anxieties, and so on are unconsciously held
out of our awareness
Reaction Formation: Impulses are repressed
and the opposite behavior is exaggerated
Table of Contents
Exit
More Freudian Defense
Mechanisms
Projection: When one’s own feelings,
shortcomings, or unacceptable traits
and impulses are seen in others;
exaggerating negative traits in others
lowers anxiety
Rationalization: Justifying personal
actions by giving “rational” but false
reasons for them
Table of Contents
Exit
Learned Helplessness
(Seligman)
Acquired (learned) inability to overcome
obstacles and avoid aversive stimuli;
learned passivity
Occurs when events appear to be
uncontrollable
 May feel helpless if failure is attributed to
lasting, general factors

Table of Contents
Exit
Fig. 15.6 In the normal course of escape and avoidance learning, a light dims shortly before the floor is
electrified (a). Since the light does not yet have meaning for the dog, the dog receives a shock (noninjurious, by the way) and leaps the barrier (b). Dogs soon learn to watch for the dimming of the light (c)
and to jump before receiving a shock (d). Dogs made to feel “helpless” rarely even learn to escape shock,
much less to avoid it.
Table of Contents
Exit
Depression
State of feeling despondent defined by
feelings of powerlessness and hopelessness



One of the most common mental problems in the
world
Childhood depression is dramatically increasing
Some symptoms: Loss of appetite or sex drive,
decreased activity, sleeping too much
Table of Contents
Exit
Mastery Training
Mastery Training: Responses are
reinforced that lead to mastery of a
threat or control over one’s environment

One method to combat learned
helplessness and depression
Table of Contents
Exit
How to Recognize Depression
(Beck)
You have a consistently negative opinion of
yourself
You engage in frequent self-criticism and selfblame
You place negative interpretations on events
that usually would not bother you
The future looks grim
You can’t handle your responsibilities and feel
overwhelmed
Table of Contents
Exit
CNN – Elderly Depression
Table of Contents
Exit
Stress and Health
Social Readjustment Rating Scale (SRRS):
Rates the impact of various life events on the
likelihood of contracting illness



Not a foolproof method of rating stress
Are positive life events (getting married, having a
child) always stressful?
People also differ in their reactions to stress
Microstressors (Hassles): Minor but frequent
stresses
Table of Contents
Exit
Psychosomatic Disorders
Psychological factors contribute to
actual illnesses (bodily damage) or to
damaging changes in bodily functioning
Hypochondriacs: Complain about
diseases that appear to be imaginary
Certain kinds of ulcers are not
psychosomatic
 Most common complaints: respiratory and
gastrointestinal

Table of Contents
Exit
Biofeedback
Applying informational feedback to
bodily control
Aids voluntary regulation of activities such
as blood pressure, heart rate, and so on
 Helpful but not an instant cure
 May help relieve muscle-tension
headaches, migraine headaches, and
chronic pain

Table of Contents
Exit
Fig. 15.7 In biofeedback training, bodily processes are monitored and processed electronically. A signal is
then routed back to the patient through headphones, signal lights, or other means. This information helps
the patient alter bodily activities not normally under voluntary control.
Table of Contents
Exit
Cardiac Personalities
Type A Personality: Personality type
with elevated risk of heart attack;
characterized by time urgency and
chronic anger or hostility
 Anger
may be the key factor of this
behavior
Type B Personality: All types other than
Type A’s; unlikely to have a heart attack
Table of Contents
Exit
Hardy Personality
Personality type associated with
superior stress resistance
 Sense
of personal commitment to self
and family
 Feel they have control over their lives
 See life as a series of challenges, not
threats
Table of Contents
Exit
General Adaptation Syndrome
(GAS; Selye)
Series of bodily reactions to prolonged stress;
occurs in three stages



Alarm Reaction: Body resources are mobilized to
cope with added stress
Stage of Resistance: Body adjusts to stress but at
a high physical cost; resistance to other stressors
is lowered
Stage of Exhaustion: Body’s resources are
drained and stress hormones are depleted,
possibly resulting in psychosomatic disease, loss
of health, or complete collapse
Table of Contents
Exit
Immunity (Similar to “Survivor”?)
Immune System: Mobilizes bodily
defenses, like white blood cells, against
invading microbes and other diseases
Psychoneuroimmunology: Study of
connections among behavior, stress,
disease, and immune system
Table of Contents
Exit
Stress Management
Use of behavioral strategies to reduce
stress and improve coping skills
Progressive Relaxation: Produces deep
relaxation throughout the body by
tightening all muscles in an area and
then relaxing them
Guided Imagery: Visualizing images
that are calming, relaxing, or beneficial
Table of Contents
Exit
CNN – Road Rage
Table of Contents
Exit
Avoiding Upsetting Thoughts
Stress Inoculation: Using positive
coping statements internally to control
fear and anxiety; designed to combat:

Negative Self-Statements: Self-critical
thoughts that increase anxiety and lower
performance
Coping Statements: Reassuring, selfenhancing statements used to stop
negative self-statements
Table of Contents
Exit
Meditation
Mental exercise designed to focus attention
and interrupt flow of thoughts, worries, and
analyses
Concentrative Meditation: Attention is paid to
a single focal point (i.e., object, thought, etc.)

Produces relaxation response and thus works to
reduce stress
Receptive Meditation: Based on widening
attention span to become aware of everything
experienced at a given moment
Table of Contents
Exit
Meditation (cont.)
Mantra: Word(s) or sound(s) repeated
silently during concentrative meditation
Relaxation Response: Occurs at time of
relaxation; innate physiological
response that opposes fight or flight
responses
Table of Contents
Exit