Stress, Coping, & Health
Biopsychosocial Model
Physical illness caused by interactions
between biological, psychological, and
sociocultural factors
Biology operates in a psychosocial
context
Health Psychology
Focuses on how psychosocial factors
relate to promotion and maintenance of
health, and the causation, prevention
and treatment of illness
Stress
Any circumstances that threaten (real or
perceived) one’s well-being, and
subsequently tax one’s coping abilities
Subjective in nature (e.g., public
speaking, flying, being supervised)
Seriousness of impending surgery
unrelated to subjective stress
Types of Stress
1 Frustration
2 Conflict
3 Change
4 Pressure
Frustration
• Occurs in any situation where pursuit of
a goal is thwarted
• Can’t get what you want
• traffic jams to unrequited love
• Unrealistic expectations and frustration
Conflict
Faced with two or more incompatible
options, motivations or impulses
Freud
Kurt Lewin (1935)
– approach-approach
– avoidance-avoidance
– approach-avoidance
Conflict
Approach-approach
choice between 2 attractive goals
win-win situation
least stressful
Conflict
Avoidance-avoidance
choice between 2 undesirable goals
lose-lose
quit miserable job vs. unemployment
highly stressful
Conflict
Approach-avoidance
Choice to pursue a single goal that has
both attractive and undesirable qualities
Promotion = pay raise + increased
responsibility
produces vacillation - back and forth
behavior, indecision
Change
Any noticeable alterations in life
circumstances that require readjustment
not obviously negative events
changes in relationships, work,
finances, etc can be stressful, even
when welcomed
Change
http://www.cygni.org/scales/social_readj
ustment_rating_scale.htm
People with higher SRRS more
vulnerable to variety of physical
ailments than lower scorers
Pressure
Expectations or demands that one
behave a certain way
Pressure to succeed at work, to publish,
to be cordial, etc
Pressures to conform to expectations of
self or others
More strongly related to measures of
mental health than SRRS and others
Responses to Stress
Emotional (annoyance, anger)
Physiological (racing pulse)
Behavioral (yelling, aggression,
avoidance)
Emotional Responses
More likely unpleasant than pleasant
Associated with negative mood
Dependent on cognitive appraisal
Event --> self-blame --> guilt, sadness
Common reactions include: annoyance,
anger, ragte, apprehension, anxiety,
fear, dejection, sadness, grief, shame,
envy, disgust, jealousy
Emotional Responses
Emotional response is motivating
(reinforcing, punishing)
Extreme emotional arousal can interfere
with coping and performance
Yerkes-Dodson Law (inverted U
hypothesis)
optimal arousal dependent on task
complexity
Physiological Response
Fight or flight: physiological reaction to
threat
autonomic nervous system mobilized for
attack or escape
evolutionary value
current adaptive value?
General Adaptation Syndrome
Hans Selye
noticed that animal physiological
responses to stress were similar
regardless of stressor
stress reactions are non-specific
coined the term stress
General Adaptation Syndrome
Model of body’s stress response
1 Alarm
2 Resistance
3 Exhaustion
• If stress can’t be overcome, body’s limited
coping resources become depleted
• diseases of adaption
Behavioral Responses
Coping: Active efforts to master, reduce,
or tolerate demands created by stress
may be positive or negative
Individuals exhibit styles of coping that
are consistent across situations
Aggression
Frustration-aggression hypothesis
not inevitable
context specific
displacement
catharsis
Self Indulgence
Excessive consummatory behavior
shopping, smoking, drinking, eating,
internet
Defensive Coping
Defense mechanisms: unconscious
reactions that protect individual from
adverse emotions (eg, anxiety, guilt)
shield from stress-eliciting events
self-deception, distortion of reality
Commonly unhealthy - avoidant
Adaptive/Constructive Coping
Relatively healthful efforts that
people make to deal with stressors
1 Confronting problems directly
• task relevant
• action oriented
• rational consideration of options
Adaptive/Constructive Coping
2 Based on realistic appraisal of stress &
coping resources
3 Recognizing and inhibiting potentially
disruptive emotional reactions
Impact of Stress on Psychology
“Choke” effect
Burnout - physical, mental, emotional
exhaustion attributable to longer-term
exposure to stressful situations
– fatigue, weakness, low energy
– negative attitudes towards self, others,
work
– hopeless, helpless
Impact of Stress on Psychology
Burnout - need to believe our lives/work
are meaningful, and our activities are
useful, important, etc
“erosion of the spirit”
Post-traumatic Stress Disorder
Exposure to traumatic event that
represented actual or threatened harm,
and response involved intense fear,
helplessness, or horror
Hyperarousal
Intrusive imagery
Avoidant behavior
Impact of Stress
Insomnia & sleep disturbance (e.g.,
nightmares)
poor academic performance
sexual problems
substance abuse
depression & dysthymia
Stress & Physical Health
Psychosomatic disorders: physical
ailment with genuine organic basis that
are caused in part by psychological
factors (emotional distress)
not imagined ailments
hypertension, ulcers, migraines, rashes,
asthma
Type A Behavior
1 Highly competitive
2 impatient
3 angry & hostile
• Type B: easy going, relaxed, amicable
• Type A associated with coronary artery,
hypertension, premature mortality
Type A
Double the risk vs. Type B
May depend on other individual factors
attributable to greater physiological
reactivity
ups and downs tax cardiovascular
system
create more stress for selves
less social support & positive coping
Proximal effects of stress
Stress as catalyst for heart attacks
Stress management training improves
outcome with cardiac patients
Depression and heart disease - cause
or effect?
Depression - unhealthy behavior
Psychoneuroimmunology
Arthritis, yeast infections, herpes, dental
disease, inflammatory bowel disease
Stress depletes and/or suppresses
immune activity - vulnerability to
infection
Student research - reduced immune
activity surrounding final exams
same for recently divorced men
Stress Moderators
Social Support
students reporting greater social
support had higher levels of antibody re:
combat respiratory infections
strength of relationship rivals cigarette-
cancer relationship
Stress Moderators
Optimism - expectance of positive
outcome
related to lower incidence of illness and
more effective immune functioning
cope in more adaptive ways
pessimists more likely to cope passively
pessimism and self-blame
Stress & Health Impairing
Behavior
Poor nutrition
Sedentary lifestyle
Substance abuse
Smoking
