Chapter 12
Stress, Coping, and Health
Behavioral Medicine
An interdisciplinary field of science that integrates behavioral &
medical knowledge & applies it to health & illness
 Health psychologists study the effects of behavior & mental
processes on health & illness.
 Biopsychosocial model: an interdisciplinary model that
assumes that health & wellness is caused by a complex
interaction of biological, psychological, and sociocultural
factors.
What Causes Stress?
 Stress: our response to events that disturb, or
threaten to disturb, our physical or psychological
equilibrium
 Stressors: external or internal events that challenge
or threaten us
Stressors
 Major cataclysmic events
 Personal major events
 Minor stressful events, called hassles
 Even positive events can tax body’s resources
and cause stress.
 negative events induce more stress than neutral or
positive events.
Mind, Brain & Body
 At any moment, your brain is creatively performing
about 400 billion actions. You are only conscious of
around 2000.
Dr. Caroline Leaf
Who Switched Off My Brain?
Mind, Brain & Body
 Dr. Candance Pert
 Brain and mind function as a single psychosomatic
network.
 The crucial link is emotions. Biochemical molecules of
emotion are like “photocopies” of thought.
Mind, Brain & Body
 The more you think, the more you understand.
 The more focused and aware you are, the stronger your
memory (dendrites firmly attached).
 During sleep, your thoughts are sorted out. Glial cells
prune dendrites.
Mind, Brain & Body
 Everything you see, hear, and feel becomes part of your
thought life.
 Thoughts are brain electro-chemical patterns.
 Negative emotions are fear based.
 Positive emotions are faith based.
Mind, Brain & Body
 The thalamus sends an electrical message to the
cortex and activates a memory.
 Your limbic system is a chemical factory.
 The amygdala is a library of emotional perceptions to
check the memory. It may dominate the cortex.
 The hippocampus will hold short-term memories for
48-72 hours.
 The hypothalamus translates the conclusion to a bodily
response.
Mind, Brain & Body
 Emotions are cellular signals that translate
information into physical reality.
 The substances used include peptides, steroids, and
neurotransmitters.
 About 90% of this process is non-conscious and 10%
conscious.
Hans Selye: Stress as a Set of Responses to
Demands
 General Adaptation Syndrome (GAS): Hans Selye’s stress
model in which an event that threatens an organism’s wellbeing (a stressor) leads to a three-stage bodily response:
 Stage 1: Alarm
 Stage 2: Resistance
 Stage 3: Exhaustion
General Adaptation Syndrome (GAS)
 Stage 1: Alarm

Upon encountering a stressor, body reacts with “fight-or-flight”
response and sympathetic nervous system is activated.
Hormones such as cortisol and adrenalin released into the
bloodstream to meet the threat or danger. The body’s resources
now mobilized.
 Stage 2: Resistance

Parasympathetic nervous system returns many physiological
functions to normal levels while body focuses resources against
the stressor. Blood glucose levels remain high, cortisol and
adrenalin continue to circulate at elevated levels, but outward
appearance of organism seems normal. Body remains on red
alert.
 Stage 3: Exhaustion

If stressor continues beyond body’s capacity, organism exhausts
resources and becomes susceptible to disease and death.
Psychophysiological (Psychosomatic) Illnesses
Are Stress Related
 Psychophysiological disorders: physical
conditions, such as high blood pressure and
migraine headaches, that are caused or
aggravated by psychological factors such as
stress
 Two bodily systems have received the most
attention.
Psychophysiological Illnesses
Are Stress Related
 The cardiovascular system is strongly affected by
stress-related emotional responses
 High blood pressure (or hypertension)
 Instances of ischemia—heart does not receive sufficient
blood
 The release of cortisol from the adrenal cortex and
epinephrine from the adrenal medulla, which ultimately
leads to artery blockage and heart attacks
Psychophysiological Illnesses
Are Stress Related
 The immune system: a complex surveillance system of
specialized cells, tissues, and organs (the body’s primary
defense against disease) reacts to and destroys cells
determined not to be part of the body.


Three important types of cells in the immune system are B cells,
T cells, and natural killer cells.
Both acute and chronic stress can reduce the efficiency of the
immune system, making the body more susceptible to disease.
Cognitive Appraisal
 Richard Lazarus (early researcher) Cognitive
appraisal is essential in defining whether a
situation is a threat, how big a threat it is, and what
resources you have to deal with the threat.
While responding, you build your mental
framework.
 You exercise your will to accept or reject information
(corpus callosum).
 Accepted information is amplified.
 Rejected information will disappear.
 You must feel something is true to believe it. Emotions
(limbic system) tells you what is real, true, and
important.
Cognitive Appraisal
Lazarus identified two cognitive appraisal stages:
(notice fear vs. faith)
 Primary appraisal: initial evaluation of situation; assess
what is happening, whether it is threatening, and whether
you should take some action in response to the threat
 Secondary appraisal: assess whether you have ability to
cope with stressor. The more competent you perceive
yourself to be, the less stress you experience.
Cognitive Appraisal
Lazarus’s model conceives of the person as an active
participant in evaluating and responding to stressors.

Problem-focused coping: a strategy aimed at reducing stress by
overcoming the source of the problem

Emotion-focused coping: efforts to manage your emotional
reactions to stressors rather than trying to change the stressors
themselves
Predictability and Control Can Moderate the
Stress Response
 Whether an event becomes a harmful stressor is
often determined by:
 It’s predictability

If you know that a stressor is coming but are uncertain when it
will occur, you experience greater stress.
 Factors related to control over it; e.g., having faith
Predictability and Control Can Moderate the Stress
Response
 If you believe that you have some control over a stressor, you usually
feel less stressed.
 When you doubt your ability to control a stressor, you are more
likely to use emotion-focused coping.
 Locus of control: the degree to which you expect that outcomes in
your life depend on your own actions rather than the environment.
 Repeated failure at trying to eliminate stressors can lead to a feeling
of learned helplessness.
Hostile & Pessimistic Persons
Are More Reactive to Stressors
 Type A Behavior Pattern
 characterized by competitiveness, impatience, ambition,
hostility, & a hard-driving approach to life is associated
with increased risk of heart disease
 Type B Behavior Pattern
 characterized by a patient, relaxed, easygoing approach to
life, with little hurry or hostility only half as likely to
develop heart disease
Hostile & Pessimistic Persons Are More Reactive to
Stressors
 Pessimistic explanatory style:
 tendency to explain cause of negative uncontrollable events
as one’s own stable personal qualities affecting all aspects of
life
 Associated with health problems and premature death
 Optimistic explanatory style:
 tendency to explain cause of uncontrollable negative events
as temporary, external factors that do not affect other aspects
of one’s life
 Associated with good health and longevity
These Patterns Can Be Changed
 Deal with old issues
 Don’t deny emotions
 Forgive
 De-guilt (make amends; forgive yourself)
 Question beliefs and assumptions
 Talk with somebody you trust
Social Support Has Therapeutic Effects
 People with more extensive social support networks are
happier, have stronger immune systems, and live longer
than those who are socially isolated.
Social Support Has Therapeutic Effects
Common benefits of social support:
 Provides increased knowledge about the stressor
 Associating with others often provides information about how to
understand and emotionally respond to stressful events.
 Provides opportunities to simply express our feelings,
which can lead to physical benefits
Religious Belief & Participation
 Religious belief & participation lower stress
 Religious services and activities allow people to assume
leadership, teaching roles
 Prayer & meditation lower stress and are associated with
longevity
Benefits of Faith
 Meaningful faith related to happiness
 Religious women had higher self-rated health
throughout life (ages 20-94); no association for men
 Studies have found that religious commitment moderates
blood pressure
 Religious participation related to longer life (42 studies)
– Health Psychology
 Prayer is associated with positive, health-related changes
Choose Your Thoughts
 Don’t unnecessarily expose yourself to negative thinking
 Don’t mindlessly take in information
 Consciously decide what thoughts to accept or to reject
 Consciously decide what thoughts to entertain
 Be conscious of what you say (especially to yourself)
Aerobic Exercise Can Increase Physical & Mental Health
 Aerobic exercise: sustained exercise that increases heart and
lung fitness
 Has a positive effect on both physical and mental health
 Activity that increases heart rate into a certain range for at
least 12 to 20 minutes fits this definition
 It is possible to overdo a good thing.
Relaxation Training Is Effective in Reducing Stress
 Many psychologists recommend relaxation training as an
effective stress antidote.
 The most basic relaxation technique is progressive relaxation,
a stress-reducing technique involving the successive tensing
and relaxing of each of the major muscle groups of the body.