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
Thoughts are brain electro-chemical
patterns.
– Negative emotions are fear based.
– Positive emotions are faith based.
Everything you see, hear, and feel
becomes part of your thought life.
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 nonconscious 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 well-being (a stressor) leads to a threestage bodily response:
– Stage 1: Alarm
– Stage 2: Resistance
– Stage 3: Exhaustion
Hans Selye: Stress as a Set of
Responses to Demands
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.
Hans Selye: Stress as a Set of
Responses to Demands
General adaptation syndrome
(GAS)
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.
Hans Selye: Stress as a Set of
Responses to Demands
General adaptation syndrome (GAS)
Stage 3: Exhaustion
– If stressor continues beyond body’s capacity,
organism exhausts resources and becomes
susceptible to disease and death.
The General Adaptation Syndrome
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
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.