Stress, Coping and Health
 Stress
 Coping
with Stress
Stress, Coping and Health
Stress is a major pathway through which
psychosoical factors affect physiology and the
aging process.
 Human are relatively resilient to the effects of
stress that can reduce or buffer its effects.
 Psychosocial stress can have negative effects
on a person’s cardiovascular and immune
systems, or can have positive effects on a
person’s growth, depending on temporal
patterning and on how we cope with it.
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Stress
 Stress
as A Physical State
 Stress
as A Characteristic of the
Environment
 Stress
as A Transaction Between the
Person and the Environment.
Stress
Stress as A Physical State (3 definitions, Mason,
1975)
 Stress – a physiological state of the organism.
 Stress – a characteristic of the environment
(stressor).
 Stress – a transaction between the person and
environment.
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Stress as a Physical State
Classic theory
 Cannon (1915) coined the term the “Fight or
flight” response that is commonly used to
describe the way in which our body reacts to
stress.
 Cannon posited that the perception of a threat
activated the sympathetic nervous system (SNS),
which readies the organism for fight or flight
through hypothalamus that responds to stress.
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Stress as a Physical State (cont)
Classic theory (two types of responses, Gevirtz 2000)
1. The sympathetic nerves directly enervate the heart,
the bronchi in the lungs, the gut, and the kidney, and
also influence the blood vessels, sweat glands, and
piloerector muscles, a short and fast time response.
2. Through sympathetic/adrenal medulla (SAM) system,
the sympathetic nerves radiate to the adrenal medulla
which secretes both epinephrine and norepinephrine
into the blood, which stimulates the organs’ muscles.
The routine through the medulla can last up to 10
times longer than the direct enervation in Figure 10.1.
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Stress as a Physical State (cont)
Cannon (1929) argued that this fight/flight
reaction, although adaptive in the short run,
could have very harmful effects if prolonged.
 It is not only humans who can be frightened to
death, this fairly common problem among
animals, example on pages 258-259.
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Stress as a Physical State (cont)
Selye (1956) expanded on Cannon’s conceptions
in two ways:
1. Corticosteriods, released by the adrenal
cortex are also elevated in response to a wide
variety of stressor. The hypothalamic-pituitaryadrenal (HPA) activation – a slower but more
sustained response (Figure 10.2).
2. Three stages in reaction to stress in Figure 10.
3 fight or flight responses.
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Figure 10. 3 The Fight or Flight Response
Stress as a Physical State (cont)
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Modern theories:
There are individual differences in stress responses in
the patterning of sympathetic arousal, Ex. some
individuals’ heart rates increased in response to stress,
but others’ heart rates decreased.
Most of the endocrine hormones are affected by stress.
Taylor et al. (2000) showed that men and women differ
in their preference for company or solitude while
awaiting a stressful procedure.
Fight-flight-affiliate, a three-dimensional response to
stress in Figure 10.3.
Stress as a Physical State (cont)
Stress and the development of chronic illness.
 Studies in animal models show that stress can result in
heart disease (Kaplan et al., 1996), and breast cancer
(Ader et al., 1991).
 Modern life is full of stress because of many factors
cardiovascular system is more prone to be affected by
stress. Hypothalamus--pituitary--adrenal axis is
activated by stress and stress elicits changes in
sympathetic - parasympathetic balance, which might
negatively affect the cardiovascular system (Kumar,
2008).
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Stress as a Physical State (cont)
Positive physiological Changes:
 In animal research, infant mice and rats subject to mild
electric shock or handling matured more quickly than
their nonstressed peers. They develop hair and opened
their eyes early, has better locomotion and reached
puberty younger ages.
 In human research, adults are taller when they are
subjected to stressors in the first 2 year (infants) of life,
childhood stress is related to earlier puberty, and
stress can induce physiological toughness if it is
followed by an adequate recovery period.
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Stress as a Physical State (cont)
Physiological stress and aging
 In aging rats, the response degrade – there is a much
slower increase in cortisol, and it takes much longer to
return to baseline.
 In humans, age-related changes in the stress response
are quite variable and somewhat contradictory.
 Sedentary middle-aged men who suddenly undertake
strenuous physical labor are vulnerable to heart
attacks.
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Stress as a Characteristic of
the Environment
Trauma:
 Traumatic stress – direct personal experience of an
event that involved serious of threat to the life or
physical integrity of self or significant others. About
20-30% of traumatic victims develop PTSD.
 PTSD – characterized by affective disturbances
including anxiety, depression, suicidal ideas, startle
reactions, nightmares, and flashbacks.
 POWs and torture victims have had high rates of
PTSD (50%).
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Stress as a Characteristic of
the Environment (cont)
Stressful life events
 They are major disruptions in individuals’ lives
due to specific occurrences such as marriage,
divorce, widowhood, and job loss.
 Negative life events tend to show modest
correlations (r = 0.2 or 0.3) with self-reported
mental and physical health outcomes, and
positive life events show little relationship to
health outcomes.
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Stress as a Characteristic of
the Environment (cont)
Chronic role strain – enduring problems linked to
social roles such as marriage, work, parenting, finances,
and health.
 Life events have adverse effects on physical and mental
health because they cause disruptions in ongoing
relations with spouses, children, jobs, and/or finances
(Pearlin et al., 1981).
 Pearlin et al. (1996) argued that a chronic role strain
becomes stressful when it spreads to another domain,
a phenomenon termed “stress proliferation”, example
of caregiver on page 270.
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Stress as a Transaction between
the Person & Environment
Psychosocial stress and aging:
 Stress arises from a combination of environmental
demands and individual vulnerabilities and resources.
 Types of stress change with age, people in the midlife
more likely to report problems with children and work,
whereas older adults re more likely to report
problems with health and retirement (Aldwin et al.,
1996).
 Age-related changes in the appraisal of stress. Older
people may be less likely to appraise a situation as
stressful. Why? (page 273).
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Coping with Stress
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Theoretical Approach to Coping
1.
Defense Mechanisms
2.
Personality-based Coping Styles
3.
Coping as a Process
Defense Mechanisms
Defense Mechanisms - are unconscious psychological
strategies brought into play by various entities to cope
with reality and to maintain self-image. Healthy persons
normally use different defenses throughout life.
 An ego defense mechanism becomes pathological only
when its persistent use leads to maladaptive behavior
such that the physical and/or mental health of the
individual is adversely affected. The purpose of ego
defense mechanisms is to protect the mind/self/ego
from anxiety, social sanctions or to provide a refuge
from a situation with which one cannot currently cope.
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Defense Mechanisms (cont)
Freud proposed three structures of the psyche or
personality:
 Id: a selfish, primitive, childish, pleasure-oriented part of
the personality with no ability to delay gratification.
 Superego: internalized societal and parental standards
of "good" and "bad", "right" and "wrong" behavior.
 Ego: the moderator between the id and superego
which seeks compromises to pacify both. It can be
viewed as our "sense of time and place“.
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Defense Mechanisms (cont)
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In Vaillant's (1977) categorization, defenses form a
continuum related to their psychoanalytical
developmental level:
Level I - pathological defenses (i.e. psychotic denial,
delusional projection, ex on page 274)
Level II - immature defenses (i.e. fantasy, projection,
passive aggression, acting out)
Level III - neurotic defenses (i.e. intellectualization,
reaction formation, dissociation, displacement,
repression)
Level IV - mature defenses (i.e. humor, sublimation,
suppression, altruism, anticipation, ex of MADD on
275).
Coping Styles
Coping styles – is a person's characteristic strategies
used in response to life problems or traumas. These
can include thoughts, emotions or behaviors.
 Ex, Women tend to have a ruminative coping style,
mulling their problems over internally, while men tend
to use distracting strategies in a effort to forget their
problems.
http://depression.about.com/od/glossaryc/g/coping_styl
e.htm
 Environmental and personality factors play a role in
coping (Schwarz & Daltroy, 1999).
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Coping Processes
Coping processes – intentional conscious strategies,
 Ideally, individuals monitor the outcomes of their
strategies and modify them to achieve their goals in the
situation.
 Five types of coping processes:
1. Problem-focused coping – cognitions and behaviors for
managing a problem.
2. Emotion-focused coping – expressing or avoidance
emotions.
3. Social support – asking for advice, help and aid.
4. Religious coping – praying and asking for help.
5. Making meaning – making sense of the problem and/or
reinterpreting it.
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Coping and Physical Health
Coping generally has positive effects, but could have
negative effects. See three models as follows:
1. Coping may have direct effects on health on page 277.
Coping may affect the progression of illness, ex,
teaching good coping skills helps immune function
and greater longevity with melanoma patients.
2. Coping and health outcome – assuming a positive
effect.
3. The contextual model – the effects of coping may
vary as a function of situational variables such as type
or severity of illness, ex on page 278.
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Coping and Aging
Gutmann (1974) reported that older individuals
become more passive copers.
 Some (Aldwin, 1991) reported that older adults used
fewer escapism or avoidant coping strategies, some
(Folkman et al., 1987) reported that older adults used
more escape avoidance.
 Labouvie-Vief et al. (1989) suggested that both
cognitive and emotional complexity increase with age,
which influences the way older individuals both
appraise and copy with stress.
 What are your thoughts about “coping and aging”?
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