Stress, Coping and Health Psychology Health Psychology- the subfield of psychology dedicated to promoting good health and

health care. It aims to: 1) investigate the psychological and social factors that influence the prevention and treatment of illness, such as habits, stress and personality traits; 2) to inform people about risky behavior and develop programs to help them lead healthier lives; 3) try to understand and improve the health-care system itself. Life-Style and Health Health problems have been called diseases or disorders of life-style because they often can be traced as patterns of behavior, including smoking, overeating, alcohol consumption, or failure to use safety devices. As the role of life-style factors has gained recognition, more and more attention is being paid in health promotion, the process of enabling people to increase control over their health and improve it. Beliefs, Attitudes, and Health Best Examples: 1. Breast cancer Beliefs: Attitudes: Most women believe the breast cancer is serious disease, but they dont know how common it is. Young women believe that breast cancer affects older women only. Women may worry about what will happen if they do find lumps. Little more than a third of women practice breast self-examination. Many do not use the right method. Because they believe that it usually affects older women, so they postpone preventive measures. Many would prefer not knowing to facing a possibly incurable problem. They would rather die that have a breast cancer. Treatment should be publicized When breast cancer is detected early, a woman has an 85-90% chance of being cured Should give explicit instructions and practice in self-examination

Health:

Cognitive Approach to Changing Health Habits In cognitive behavioral therapy, both the unhealthy habit and the beliefs that accompany it are targets for change. Initially, this therapy change may come from a therapist, a physician, or a formal group program. But, ultimately it is the client who must carry out the behavior change on his or her own. Most Successful Programs are the following: 1. Multimodal Approach a. involves self-observation and self-monitoring Clients keep a detailed record of the target behavior The record helps the therapist and client identify the thoughts, feelings, or circumstances that elicit the unwanted behavior, as well as the dimensions of the problem. b. Remove the stimuli that trigger the undesirable behavior The goal of stimulus control is to eliminate unthinking, reflexive behavior and make it more difficult to indulge in the unhealthy behavior. c. Self-reinforcement, change the pattern of self-reinforcement that maintain the unhealthy habit. Shaping, a schedule of rewards for cutting Goal: change the consequences of behavior; it is associated with rewards rather than experienced as punishment 2. Contingency Contracting- a person makes a contract with another individual detailing the rewards or punishment contingent on succeeding or failing to make a behavior change. 3. Cognitive Restructuring- people who are giving up old habits often feel as if they are losing a close friend. The therapists help the client to reverse this cognitive pattern, by focusing on gains rather than losses. 4. Skills training- to help the client deal more adaptively with the situations that evoked the unwanted behavior in the first place. The great advantage of multimodal approach is to allow the therapist to tailor a program to fit the needs and problems of each client. Is the negative emotional and physiological process that occurs as individuals try to adjust to or deal with stressors.

Stress

Stressors are environmental circumstances that disrupt or threaten to disrupt peoples daily functioning and cause people to make adjustments. Ex. Physiological stressors Catastrophic events- accidents, assaults or natural disasters Life changes and strains- divorce, family illness, unemployment Chronic stressors- noisy airport, discrimination, being bullied, under threat of terrorism Daily hassles- traffic, o Stress Reactions are the physical, psychological, and behavioral responses that occur in the face of stressors. Fight-or- flight response- when one perceives a threat, the sympathetic nervous system and endocrine system are aroused to enable the organism to attack the invader or to flee. o General Adaptation Response (GAS) by Hans Selye o Refers to the physiological reactions one makes to stressors. o Three phases how an individual react to a stressor Alarm stage- which activates the sympathetic division of the ANS; the organism becomes mobilized to meet the threat. Resistance stage- where the drain on the body resources continues; the organism tries to come to terms with the threat- through confrontation. Exhaustion stage- when bodily resources become nearly depleted Illustration: student reaction during exam time and how health was affected *repeated and prolonged exposure to stress causes wear and tear on the body Individuals differ in the way they respond to similar events. What some people find stressful others find benign and even beneficial or exciting. One determinant of whether or not we feel stress depends on how we evaluate or appraise a situation.

Stress and the Immune System How does stress affect the body? What is the relationship between stress and illness? According to the study conducted in group of med students, the levels of lymphocytes , how active and responsive they were, and even the amount of interferon secreted by NK cells were all significantly lower during exams. The implication was clear: academic stress compromises immunity, making students more vulnerable to illness. Stress and Life Events Adapting to a major life event, good or bad, always causes stress, but a stressful event isnt necessarily a threat to health . Some people dread their retirement as a kind of living death; for others, its a chance to try new expe riences and get more enjoyment out of life. Any life change-whether positive and negative is stressful. The reason is that changes in the external circumstances of our lives force us to adapt; old habits must be given u and new patterns established. Chronic Stress and Daily Hassles Chronic stress might affect people both directly, exhausting their resources for coping, and indirectly, making it more difficult to cope with other major life events or even with daily hassles. Ex. Wives of soldiers according to them, waiting and wondering (chronic stress) were worse than knowing their husbands were in combat (acute stress) many had to adjust to the role of single parent; the possibility that their husbands might be killed in combat Loss of job a single event that has multiple, often long-lasting repercussions (struggling to pay bills, looking for a new job, etc.) Daily Hassles, severe daily hassles decline physical health; it may be more stressful and more harmful to our health than major misfortunes. However, some says, that it reflects an already existing state of psychological distress. Hence, feeling hassled might be a symptom, not the cause, of mental and perhaps physical health problems. POST TRAUMATIC STRESS SYNDROME Is a pattern of severe negative reactions following a traumatic event. Its symptoms include hyperalertness, sleep disturbances, guilt for having survived when others have not, memory loss, and emotional distance.

BURNOUT

Is an intensifying pattern of physical and psychological dysfunction due to a continuous flow of stressors or to chronic stress. People experiencing burn-out may become uncharacteristically apathetic, impulsive, accidentprone, irritable and depressed.

Individual Differences and Stress Why doesnt everyone react to stressors in the same way? A. How stressors are perceived B. Predictability and Control C. Coping Resources and Coping Methods 1. Problem- focused coping methods try to alter or eliminate source of stress 2. Emotion-focused coping methods try to regulate the negative emotional consequences of stress D. Social Support- consists of emotional, tangible, or informational resources provided by other people. E. Personality and Gender In general, men tend to get angry and/or void stressors, and women tend to help others and use social support. Type A Personality, one associated with risk of CHD(coronary heart disease) as hostility- especially a combination of cynicism, suspicion, resentment, antagonism and frequent outburst of anger; predisposed to appraise events and actions of others as threatening; their only option for coping is fighting, not flight or compromise. This style might be adaptive in competitive situations (in business/sports), but maladaptive over the long run, increasing stress and the risk of CHD. Optimism VS. Pessimism High optimism were less likely to report being bothered by physical symptoms (headaches, upset, stomachs, and the like) than students who had scored lover on the scale. Pessimist had almost twice as many infectious diseases, visited physicians twice as often Optimists are confident that good things will happen and that they will be able to manage whatever problems life throws their way Pessimist can have lifelong negative effects; by implication, they have significantly poorer health In terms of recovery from illness, pessimist died sooner; optimist recovered more quickly. By implication, optimism is a good medicine. Other effects of positive thinking Little optimism can be healthy, too much can be maladaptive o Unrealistic optimism can lead people to deny problems until it is too late to cope o To assume they have control in uncontrollable situations Optimism leads to blaming the victim. o The idea that individuals can conquer serious illness through sheer willpower is based on a misreading of the scientific literature All these results and implications are based on studies. Result are reported in terms of probabilities, not cause and effect. Stress and Illness Stress affects health in a variety of ways. o Direct route: stress may produce physiological and psychological changes that contribute to the illness But not everyone who is under stress gets sick; why? Due to personality an individual Altering health behaviors Stress may promote illness behavior Factors may interact Coping with Stress Coping is the process of managing the internal and external demands that one appraises as taxing or overwhelming. Two main forms of coping Problem-directed coping- attempts to do something constructive about the stressful situation Emotion-focused coping- efforts to regulate the emotional consequences of a stressful situation Coping Strategies Confrontational coping- standing your ground and fighting for what you want Social support- turning to others for comfort and advice on how to handle the situation Planful problem solving- devising a plan of action to solve situation

Problem-directed

 Self-control- keeping your shin up and not letting your feelings show. Distancing- telling yourself, Im not going to let this get to me. Positive reappraisal- looking for the silver lining Accept responsibility- acknowledge that you brought this yourself, emotion-focused and try to learn from the experience (ex. I was late all the time; I didnt try my best as I could have) Escape/avoidance- engaging in wishful thinking (maybe my boss will change her mind), or escaping through drugs, drinking, or overeating Venting emotions, or catharsis (from the Greek word, to cleanse) Confiding or talking about stressful events with others to ease tension and frustrations. Talking with others can provide us with useful information about how to cope; it can also assure us that we are not alone, that others have faced the same problems and feelings. It can help us to organize our thoughts and perhaps find meaning in the experience Social Support and Stress Aside from internal resources in managing stress we also have external resources- our social support system Social support is the information we obtain from others that we are loved, cared for, valued, and included in a network of mutual concern. Sources of support- friends, spouses, lovers, children, church members, club members, or even a devoted pet.

Forms of social support a) Tangible assistance- take the form of a gift of money to tide a person over some bad times or even something so small as meals provided during a time of bereavement. b) Information- may give a person ideas on specific actions to take to overcome a stressful situation c) Emotional support- given by family and friends, reassuring the individual experiencing stress that others care for him or her. Research has shown that social support effectively reduce distress at times of stress o Lower likelihood of illness, speed recover, and reduce the risk of death from serious disease You do not need to have great numbers of social support, having at least one confidante to who one can turn; too many people provide advice or support may increase stress- they may provide the wrong advice.

Most common unhelpful advice: You can always have another child; A trip would do you a word of good; Its a good thing you have other children- for bereavement Judged as helpful advice: just being there- providing opportunity to discuss feelings and expressing concern Positive and negative behavior that can hinder or help a persons attempts to quit smoking Negative behavior o Comment that the house smells of smoke, refuse to let you smoke in the house, talk you out of smoking a cigarette. Positive Behavior o compliment you on not smoking, tell you to stick with it Training in Stress Management Stress management a technique workshops in stress management to those who cannot reduce stress through either their own efforts or with the support of others. Biofeedback o A new technology, a specialized procedure for monitoring and controlling the physiological aspects of stress (and pain). The individual is given feedback on a body function that is normally outside conscious awareness and trained to recognize and control it. Recommended for the treatment of hypertension, chronic pain, muscle contraction headaches, migraines as well as general stress. Directed at people who suffer from or at risk for stress-related illness or disorders , such as headaches, migraines, obesity , cardiovascular disease, and hypertension Best example of is the COGNITIVE- BEHAVIORAL TECHNIQUES

Relaxation Techniques

Help a person learn to shift the body into this pleasant state of low arousal and to reduce states of abnormal tension associated with stress. o Effective for treating insomnia, hypertension, tension headache, anxiety disorders. 1. Progressive relaxation- technique that focuses on the different muscle groups in the body 2. Controlled breathing- states of relaxation are associated with deep, long breaths; we can induce relaxation by intentionally trying to create this breathing pattern. Benefit of Relaxation Improve the functioning of the immune system

Exercise natures own prescription for managing stress A healthful way to use the bodys preparation for action. Best kind of exercises: aerobic- swimming, walking, running, cycling, dancing, jumping rope- any activity that demands increased oxygen intake and thus gives the cardiovascular system a workout. o To be effective, it must be consistent Improve moods and general sense of well-being, help reduce anxiety, depression and tension o People with regular exercise program tend to have a more positive self-image, greater selfesteem, and a higher sense of self- efficacy.

People can play an active role in establishin g healthy habits and learning to cope with stressful conditions: we can eat regular and nourishing meals, not smoke, not drink to excess, not abuse drugs, develop positive (yet realistic) attitudes, exercise routinely, and , occasionally, just slow down a nd relax.