WK 6 - STRESS, COPING & HEALTH

Question 1

Stress

Answer 1

A physical, cognitive, emotional and behavioural reaction of an individual to any circumstance (real or perceived) that threatens, challenges or exceeds the individual’s coping resources

Question 2

Stressors in modern society

Answer 2

Catastrophes (war, earthquake, famine), significant life changes (leaving home, getting married), daily hassles (road works, assignments, work)

Question 3

Functions of stress (+)

Answer 3

When short-lived or perceived as a challenge, stressors can have positive effects (fight or flight) > arousal motivates us to solve problems

Question 4

Functions of stress (-)

Answer 4

Extreme/prolonged stress can also be maladaptive > prolonged (chronic stress) or excessively severe stress increases our risk of illness and health problems

Question 5

Stress response

Answer 5

Stress response (fast) is a fight or flight response marked by the outpouring of adrenaline and noradrenaline from the inner adrenal glands, increasing heart rate and respiration rates, mobilising sugar/fat and dulling pain

Question 6

Theories of stress

Answer 6

1) General adaptation syndrome (Hans Selye) > response based view of stress and concentrates more on the biological aspects of the stress response
2) Lazarus’ view (Lazarus and Folkman) > interactionist approach

Question 7

General adaptation syndrome (Selye)

Answer 7

Response is the same regardless of the stimuli, whether it is physical or emotional, viewed as positive or negative

Question 8

Lazarus’ view (primary appraisal)

Answer 8

Remember stress refers to any circumstance (real or perceived) that threatens a person’s well-being > e.g. a new job could be exciting (opportunity) or scary (potential failure) according to your primary appraisal

Question 9

Lazarus’ view (secondary appraisal)

Answer 9

How well do you expect to cope > availability of resources is weighed up vs demands (what is the likelihood that I will overcome this?)

Question 10

Developmental influences

Answer 10

Perception/reports of stress typically decrease with advancing age

Question 11

Symptoms of stress

Answer 11

1) Physical > muscular aches, pains, nervous tic, breathing changes, butterflies, sweating, constipation, itchy, grinding teeth, frigidity
2) Psychological > fear, anxiety, panic, worry, depression, guilt, anger, low confidence, memory lapses
3) Behavioural > drug use, alcohol use, over/under-eating, aggression, stuttering, crying, nagging, reduced work performance

Question 12

Stress and illness

Answer 12

1) Psychoneuroimmunology > how our thoughts and feelings impact the brain, and in turn influence hormones and immune system functioning
2) Psychophysiological illness > a stress related illness, differs from ‘psychosomatic’ which implies that the physical symptoms are not real
3) Stress trigger immune suppression > fewer disease-fighting lymphocytes (WBC), stress linked to infection, asthma, chronic fatigue, headaches, insomnia, heart disease

Question 13

Stress and colds

Answer 13

Development of colds > 47% in stressed and 27% low stress

Question 14

Stress and healing

Answer 14

Stress can impact healing > wounds heal 40% more slowly in stressed students before exams than on vacation. Stress and negative emotions can accelerate the progression of HIV to AIDS and the speed of decline > reducing stress had positive effects. Stress does not create cancer cells, but can weaken our ability to fight cancer

Question 15

Stress and heart disease

Answer 15

Coronary heart disease is the leading cause of death in Australia > significant influence of psychological states including stress, anger, pessimism and depression. May also occur via maladaptive coping behaviours

Question 16

Occupational stress

Answer 16

Demands are associated with high levels of strain > demands can be offset by perception that one has control over aspects of the work of commensurate rewards

Question 17

Managing stress

Answer 17

Relaxation programs were used to help Type A heart attack survivors reduce their risk of future heart attacks > lifestyle change to slow down, relax pace, smile, laugh, admit mistakes, find enjoyment (repeat heart attack was halved). First we appraise threat or challenge , then what we do is dependent on a number of factors

Question 18

Personality: traits and types

Answer 18

1) Neuroticism and negative affectivity > linked to attention to internal states and increased somatic complaints
2) Type A > competitive, drive, inpatient, verbally aggressive and anger-prone people
3) Type B > refers to easy-going and relaxed people

Question 19

Personality: pessimism vs optimism

Answer 19

1) Pessimist > tend to interpret stressors as uncontrollable, long-lasting and generalised to many life domains
2) Optimist > tend to report stressors as temporary, controllable and specific to one’s situation (optimism associated with less fatigue, fewer colds and even longer lifespan)

Question 20

Perceived control

Answer 20

The belief we can perform the behaviour necessary to cope successfully (or have control over the outcome) > is important and protective against stress: sub-ordinate rat more susceptible to ulcers, whereas executive rat was no different from control (despite shocks)

Question 21

Coping self-efficacy

Answer 21

Self-efficacy is specific to the situation > previous successes in similar situations will increase efficacy, whilst failures undermine it. Can also increase efficacy by: observing other people cope successfully, through encouragement from others (e.g nursing home residents who have more control over their environment tend to cope better and live longer)

Question 22

Coping strategies

Answer 22

1) Problem focused > confront and directly deal with the demands or remove it (e.g. action plan for study)
2) Emotion focused > deal with the emotional responses that result from a stressful situation (e.g. addressing the anxiety) - especially in low perceived control
3) Social support seeking > turn to others for assistance (e.g. emotional support)

Question 23

Benefits of social support

Answer 23

Reduced blood pressure, increase immune functioning, greater sense of purpose, inversely associated with loneliness (risk factor), increased sense of control over stressors and supports prevention of maladaptive coping strategies (e.g. drinking to cope with stress)

Question 24

Three types of benefits

Answer 24

1) Tangible assistance > provide goods and services in stressful circumstances (e.g. meals, money, mowing the lawns)
2) Information > recommended specific actions and plans to help cope more successfully (e.g. time management advice)
3) Emotional support > buffer/prevent development of depression, anxiety and low self-esteem (e.g. providing reassurance)

Question 25

Techniques for managing stress

Answer 25

1) Exercise > adding quality of life, improving mood, fighting health conditions
2) Relaxation > body can’t be both tense and relaxed at the same time - focus on relaxation temporarily takes the focus away from the problem (e.g. may involve visualisation and centring)
3) Biofeedback > uses electronic devices to inform people about the physiological responses (similar to prompted relaxation - effective for tension headaches)
4) Personal strategies > recognise signs early, identify tension, target relaxation, slow down breathing, change self-talk to be more positive, manage your environment

Question 26

Promoting health

Answer 26

Promoting health is generally defined as the absence of disease (e.g. preventing disease). We only think of health when we are ill, however psychologists say that promoting health begins by preventing illness and enhancing wellbeing > thus stress management is an important component of overall strategies to promote health

Question 27

Coping with chronic illness

Answer 27

Most of us will experience one. Reaction to diagnosis of a chronic illness is shaped by a number of factors > social support, coping skills, personality, illness characteristics and impacts on daily functioning

Question 28

Chronic illness: diagnosis

Answer 28

Initial > questioning (is the diagnosis right, what can we do, will I die, what will happen to my family). Leads to emotional and physical reactions

Question 29

Chronic illness: reaction sequence

Answer 29

Initial reactions usually follow a sequence:
1) Shock (emergency) > out of body experience, detachment and ‘autopilot’
2) Encounter > confused and disorganised thinking, feeling overwhelmed by loss, grief, helplessness and despair
3) Retreat: begin to confront their illness, little at a time (may begin with avoidance strategies like denial)

Question 30

Chronic illness: avoidance strategies

Answer 30

1) Benefits: controls initial emotional responses, provides early psychological benefits
2) Costs: gain less info about illness, affect immediate major decision-making about treatment, may not take action to promote recovery, may not adjust to family, social and work situations to promote health

Question 31

Chronic illness: emotional responses

Answer 31

Shock of diagnosis often leads to intense emotional responses: confusion, numbness, denial, guilt, fear, helplessness, anger, loss of control, sadness and hope

Question 32

Chronic illness: initial physical responses

Answer 32

Compared with emotional responses there are more short-lived > physically ill after hearing the news, more susceptible to small illnesses, maladaptive coping strategies, these extend beyond the patient to loved ones

Question 33

Crisis theory

Answer 33

Illness-related factors, personal factors and physical/social environmental factors > cognitive appraisal (perceived meaning of illness) > adaptive tasks > coping skills > outcome of crisis

Question 34

Illness-related factors

Answer 34

Some health issues present a greater threat to life than others > others may be disabling, disfiguring or painful (nausea). Self-conscious of difference, equipment, changes in body function

Question 35

Background/personal factors

Answer 35

Those who cope well have adequate psychological and behavioural resources to do so. Pre-existing emotional issues = tend to do poorer. Factors include age, gender, SES, religion, emotional maturity and self-esteem

Question 36

Physical/social environment factors

Answer 36

Physical aspects of hospital can exacerbate poor mood and/or contribute to increase fear and anxiety. Social environment is a dynamic system, each individual influences other. Presence of social support, family, generally associated with better coping and adjustment > facilitates emotion-focused coping

Question 37

Crisis theory: the coping process

Answer 37

Two kinds of adaptive tasks:
1) Those related to the illness > problem-focused coping assists (managing symptoms, treatment, build good relationships with medical staff)
2) Those relating to general psychosocial functioning > emotion-focused is more relevant (e.g. maintain positive outlook, minimise negative emotions)

Question 38

Possible adjustment problems

Answer 38

Physical (disability/pain), vocational (career plans), self-concept (body image), social (change activities/relationships), emotional (anxiety/depression), compliance (rehab/treatment)

Question 39

Ideal treatment

Answer 39

Multi-disciplinary health teams may consist of a number of health professionals > working together to help a person rehabilitate after an accident or illness

Question 40

Psychosocial interventions

Answer 40

May consider employing psychosocial interventions, involving > education, behavioural methods, stress management, biofeedback, cognitive approaches, insight therapy and family therapy

Question 41

Stress

Answer 41

Stress refers to any circumstance (real or perceived) that threatens a person’s wellbeing

Question 42

Lazarus’ view

Answer 42

Lazarus proposed that stress was a transaction between the individual and the environment > the individual makes a cognitive assessment (appraisal) of the demands of the stressor and the coping strategies available to them. Primary and secondary appraisal carried out simultaneously

Question 43

Cognitive appraisal

Answer 43

The process of perceiving the stressor and of judging one’s ability to manage or respond to the stressor

Question 44

Primary vs secondary appraisal

Answer 44

1) Primary > identify is the stressor is a threat (negative) or challenge (positive)
2) Secondary > examine resources vs demands

Question 45

Stress appraisal measure (SAM)

Answer 45

Measures dimensions of primary and secondary appraisals

Question 46

SAM: primary

Answer 46

Comprises of three sub-scales designed to measure primary appraisal dimensions of anticipatory stress. Threat = potential harm/loss in the future, challenge = anticipation of gain/growth, centrality = perceived importance of well-being

Question 47

SAM: secondary

Answer 47

The SAM also includes three scales to measure secondary appraisal with a focus on perceptions of control:
1) Extent controlled by self
2) Extent controlled by others
3) Uncontrollable by anyone

Question 48

Daily hassles and uplifts

Answer 48

1) Daily hassles: minor irritating and frustrating everyday events
2) Uplifts: minor positive everyday events