Chapter Fourteen: Stress, Coping, and Health

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The Nature Of Stress Two of many definitions of stress:

A reaction to environmental demands Stress: is any circumstances that threaten or are perceived to threaten one's well-being and that thereby tax one's coping abilities. Threat may be to immediate physical safety, long-range security, self-esteem, reputation, peace of mind etc. 20-25% of Canadians report that most of their days are either quite or extremely stressful, this will impact their health -reaction to environmental demands impacts health

Frued:

theorized that behaving aggressively could get pent-up emotion out of one's system and thus be adaptive Catharsis: to refer to this release of emotional tension Experimental research generally has not supported the catharsis hypothesis, most studies find just the opposite: behaving in an aggressive manner tends to fuel more anger and aggression

Communicating with Health Providers

A large portion of medical patients leave their doctors not understanding what they have been told There are barriers to effective communication, economic realities dictate that medical visits are quite brief Many providers use too much technical terms Patients forget to ask what they want to ask

Smoking

21.4 percent of Canadians males and 14.8 percent of Canadian females continue to smoke Smokers ingest more than 7000 chemicals in each puff on a cigarette. The chemicals rapidly spread throughout the body causing widespread cellular damage, this is the leading cause of premature death in North America Smokers face a much greater risk of premature death than nonsmokers, they have 13-14 years shorter than that of a similar nonsmoker Smoking increases the likelihood of developing a surprisingly large range of diseases Lung cancer and heart disease kill the largest number of smokers, they also have an elevated risk for oral, bladder and kidney cancer as well as cancers of the larynx, esophagus and pancreas for arteriosclerosis, hyperextension, stroke and other cardiovascular diseases and for bronchitis, emphysema Family members and co-workers who spend a lot of time around smokers are exposed to second-hand smoke or environmental tobacco smoke Second-hand smoke can increase their risk for a variety of illnesses, including lung cancer and heart disease If people can give up smoking their health risks decline reasonably quickly, most smokers would like to quit but are reluctant because it is their major source of pleasure It is possible to quit smoking successfully, readiness to give up smoking builds gradually as people cycle through periods of abstinence and relapse Long-term success rates are in the vicinity of 25 percent

Classification of Stressors by magnitude

Ambient stressors (minor, air conditioner going on and off) Daily Hassles (having trouble getting to class due to blockage) Stressful life events (getting married) Cataclysmic events (being in a car accident)

Cognitive Behavioural Therapy

Anxious and uptight due to thoughts, notice thoughts , study reactions Not tricking people into positive thoughts but have people study situations and reactions to see if there is a better way of seeing things rather than being stuck to a negative and threatening way. Or cognitive habits that makes them feel miserable detect and dispute detect bad thoughts you are having then see if you can challenge those thoughts

Why exercise helps people live longer

Appropriate exercise enhances cardiovascular fitness and reduces susceptibility to deadly cardiovascular problems Exercise can indirectly reduce one's risk for a variety of obesity-related health problems such as diabetes and respiratory difficulties Exercise can diminish chronic inflammation Exercise can serve buffer that reduces the potentially damaging physical effects of stress, this buffering effect may occur because people high in fitness show less physiological reactivity to stress than do those who are less fit Among the elderly, exercise is associated with a reduction in brain shrinkage normally after 60 and a reduction to Alzheimer's disease

Am I really sick?

Attend to bodily sensations Interpret sensation in the context of illness Negative mood Information and self-regulatory theory take in information, drink, stay up late, take it easy and still have headache what you do in response to body's symptoms based on information

Stress Mindset/ management

Attitudes and beliefs about stress and its effects influence your capacity to handle stress effectively Stress-is-debilitating mindset: Most people assume stress is generally harmful Stress-is-enhancing midwest should be associated with intermediate arousal in response to stress and more effective coping strategies Positive Effects Of Stress Most people seem to operate under the impression that the effects of stress are entirely negative Increased interest in the positive effects of stress including favourable outcomes that follow in the wake of stress this emphasizes "positive psychology" encourages well-being, courage, perseverance, tolerance and other human strengths One of these strengths is the resilience of stress Stressful events force people to develop new skills, re-evaluate priorities, learn new insights and acquire new strengths Adaption process initiated by stress can lead to personal changes for the better Insight: making the best of a difficult situation

Behavioural Responses

Behaviour is the crucial dimension of their reactions. Most behavioural responses to stress involve coping Coping: refers to active efforts to master, reduce, or tolerate the demands created by stress Handled the problem effectively Coping responses may be adaptive or maladaptive

Changing patterns of illness

Contagious vs chronic illnesses increase in Heart disease, cancer and stroke caused by lifestyle

Reactions to Illness

Deciding to seek treatment Sensations as symptoms depends on individual interpretation When two people experience an unpleasant sensation, one may shrug them off as a nuisance while the other may rush to a physician People who are relatively high in anxiety and neuroticism tend to report more symptoms of illness than others do

What are effective coping strategies? Everyday methods

Deep breathing Neck and shoulder rolls Laughter Hot baths Listening to music Getting up early Making a game plan We often lose traditional coping techniques because of change and modernization

Bluneters and monitors: delay vs on top of things

Delays: Appraisal delay - detect symptoms think you're sick Illness delay - you know there is something wrong don't want to call the doctor Behavioral delay Scheduling delay Treatment delay

Some individual patterns of stress reaction (Howard 1978)

Emotional distress (insomnia, fatigue, change of appetite, moodiness, depression) Medication use (pills, pain , sleeping, diet pills, tranquilisers, recreational drugs, food) Cardiovascular symptoms (high blood pressure, coronary heart disease, rapid heart beat) Gastrointestinal symptoms (ulcers, colitis, digestive problems, nausea, diarrhea) Allergy respiratory symptoms (allergies, skin problems, respiratory problems) *under stress body has less ability to handle pollen allergy and sneeze more powerfully Because your culture has reacted to the world in a particular way it's not always helpful The way we react to situations can affect our health more stress these are more likely to happen younger people, females, Mediterranian more emotional and expressive

Effects of Emotional Arousal

Emotional responses are a natural and normal part of life even unpleasant emotions serve a important purpose, pain is a warning that one needs to take action Strong emotional arousal can also interfere with efforts to cope with stress The inverted-U hypothesis: predicts that task performance should improve with increased emotional arousal up to a point after which further increases in arousal become disruptive and performance deteriorates under or overestimated performance goes down, degree of effective performance and how you deal with it

Change

Experiencing life changes including positive events represent a key type of stress Relationship with change and illness

Thoughts and Feelings: Mathew MacKay: Distorted Thinking

Filtering: magnify negative details only and filter out positive aspects don't see big picture Polarized thinking: must be perfect or you're a failure Overgeneralization Mind Reading Catastrophizing: expect disaster and feel it will happen Personalization Control Fallacies Fallacy of fairness Balming Shoulds Emotional reasoning Fallacy of change Global labelling Being right Heaven's reward fallacy (expect sacrifice and self denial to pay off, if there were someone keeping score, you feel better when the reward doesn't come) - someone stole ideas for job interview, don't get upset about something while the people who stole it are eating a danish being hostile for no reason (try to seek justice if you can if not accept things that are unfair) -when your tired old habits that are ingrained pop up People who are depressed see things differently from optimistic, stable,global, internal (depressed) temporary, not global, situational (optimist)

Get in shape

Fitness Physically Emotionally Financially Socially Spiritually -to meet challenges and manage stress -getting rid of stress hormones, mobilizes to action

Personality, Hostility, and Heart Disease

Heart disease remains the leading cause of death in North America Coronary heart disease: involves a reduction in blood flow in the coronary arteries, which supply the heart with blood This disease accounts for about 90% of heat-related deaths, established risks include smoking, lack of exercise, high cholesterol levels, and high blood pressure Inflammation plays a key role in the initiation and progression of coronary disease as well as the acute complications that trigger heart attacks high levels of anger can literally kill you anger and coronary risk The connection between coronary risk and Type A personality which involves self-imposed stress and intense reactions to stress The Type A personality includes three elements: a strong competitive orientation, impatience and time urgency, and anger and hostility Type A's are ambitious, hard-driving perfectionists who are exceedingly time-conscious, highly competitive, irritable workaholics who drive themselves with many deadlines (double the rate of heart disease) see everything as a challenge and negativity A cynical view, 5x more heart disease due to hostility hostile people causing themselves harm cynicism and heart disease makes sense psychologically produce more stress hormones , since these hormones accelerate plaque build-up find themselves dying sooner

Routes by which stress may produce disease Health habit effort:

increased smoking, alcohol use, decreased nutrition, decreased sleep, increased drug use

Alcohol and Drug Use

Heavy consumption of alcohol clearly increases one's risk for a host of diseases Drugs can kill directly and immediately when they are taken in an overdose or when they impair the user enough to cause an accident And also elevates one's risk for infectious diseases, respiratory, pulmonary, and cardiovascular diseases, liver disease, gastrointestinal problems, cancer, neurological disorders, pregnancy People take drugs or stimulants, alcohol, caffeine, tobacco to relax Puts to sleep our parasympathetic before sympathetic nervous system that slows things down or reserves energy Relaxation response/stress response and stress management

Emotional Reactions, Depression and Heart Disease

Hippocampus shrinks under cortisol that is associated with depression People's emotions can also contribute to heart disease, transient mental stress and the resulting emotions people experience can tax the heart Do behaviours to achieve success/goals but behaviours don't stop dying younger: precocity longevity hypothesis Strong emotional reactions might trigger heart attacks in individuals with coronary disease Depression is caused by stress and related to heart disease, may cause a release of stress hormones due to feeling overwhelmed Brief periods of mental stress can trigger sudden symptoms of heart disease Mental stress can elicit cardiac symptoms in about 30-70 percent of coronary patients Two hours immediately following an outburst of anger there is nearly a fivefold jump in an individual's risk for a heart attack and a more than threefold increase in the risk for a stroke Depressive Disorders are characterized by persistent feelings of sadness and despair are a fairly common form of mental illness Elevated rates of depression have been found among patients suffering from heart disease, heart disease makes people depressed The emotional dysfunction of depression may cause heart disease Participants who suffered from depression were 2.7 times more likely to die of heart disease during the follow-up period than people who were not depressed because the patient's depressive disorders preceded their heart attacks, it can't be argued that their heart disease caused their depression Depression roughly doubles one's chances of developing heart disease

Lack of Exercise

Lack of exercise and increase in sedentary activities such as watching TV to poor health and obesity Regular exercise reduces the risk of many health problems including cancer, obesity, high blood pressure and several types of psychopathology is associated with increased longevity. Also reduces risk of diabetes Public Health Agency of Canada recently adopted the World Health Organization recommendation of 150 minutes 17 percent of men and 14 percent of women currently achieve this level of exercise Exercise level declined from 1981-2009 among youth ages from 15-19 Kids in Canada only spend 14 minutes on average after school engaged in physical activity, spending time on TV puts them at increased risk for obesity and a link on deceased cognitive and social development Canadian Kids are spending up to eight hours in front of the screen on a typical day

Health-Impairing Behavior

Life expectancy for Canadians is increasing for women is 83 and men is 79 World health organization

People delay because they:

Misinterpret and downplay the significance of their symptoms Fret about looking silly of the problem turns out to be nothing Worry about bothering their physician Are reluctant to disrupt their plans Waste time on trivial matters

Cognitive style: Optimism, Conscientiousness and Hardiness

Optimism: is a general tendency to expect good outcomes (live longer) believe you can achieve it Correlation between optimism and good physical health, more effective immune functioning, greater cardiovascular health and increased longevity Optimists cope with stress in more adaptive ways, engage in action-oriented, problem-focused coping and are more likely to emphasize the positive in their appraisals of stressful events (Albert Bandura and achievement) Enjoy social support Optimism is not the only personality trait that has been examined as a possible moderator of the relationship between stress and health Conscientiousness is associated with good physical health and increased longevity (seek out environments that bring out the best in them) People who are conscientious are less likely than others to exhibit unhealthy habits, excessive drinking, drug abuse, dangerous driving, smoking, overeating and risky sexual practices They tend to rely on constructive coping strategies and they are persistent in their efforts so handle stress better Conscientiousness appears to promote better adherence to medical advice and more effective management of health problems, which both foster career success and increased income, people high in conscientiousness tend to end up in the upper levels of socioeconomic status (seek out environments that will bring out the best in them) High SES confers a host of advantages that promote greater health and longevity Wealthier people tend to endure lower levels of stress, benefit from better nutrition and more exercise, exhibit fewer unhealthy habits, are exposed less to pollution and work in less toxic environments, can afford easier access to higher-quality medical care Tend to withstand the demands of stress better than others

Emotions Commonly Elicited

Our emotions go through phases during and after a stressful event The emotional fallout can continue for a long time Researchers have begun to uncover some strong links between specific cognitive reactions to stress (appraisals) and specific emotions self -blame tends to lead to guilt, helplessness to sadness and so forth Common emotional responses to stress include: annoyance, anger and range, apprehension, anxiety and fear and dejection, sadness and grief Research shows that positive emotions also occur during periods of stress In the face of disasters people are still able to feel gratitude for their own safety Positive emotional style is associated with an enhanced immune response Positive emotions also appear to be protective against heart disease Positive emotions in relation to longevity People who experience a high level of positive emotions appear to live longer than others

Striking Out At Others

People often respond to stressful events by striking out at others with aggressive behaviour. Short term resolvement damages the social support system. (displacement theory by Freud find a different source to take out anger) Aggression: is any behaviour that is intended to hurt someone, either physically or verbally The frustration-aggression hypothesis: which held that aggression is always caused by frustration Research has shown that there isn't an inevitable, one-to-one correspondence between frustration and aggression

Coping techniques

Task-oriented coping: behaviours you do to overcome challenges directly Emotional-oriented coping: calm oneself down to get things done (sometimes we have no control over stressor must calm down and accept it) Avoidance-oriented coping: do behaviours to distract yourself from the problem

Giving Up and Blaming Oneself

People sometimes simply give up and withdraw from the battle, some people respond to stress with fatalism and resignation, passively accepting setbacks that might be dealt with effectively this is called learned helplessness Learned helplessness: is passive behaviour produced by exposure to unavoidable aversive events Behavioural disengagement leads to depression (behavioural investment trap) When individuals come to believe that events are beyond their control Learned helplessness can contribute to depression When people struggle to pursue goals that turn out to be undesirable People who are better able to disengage from unattainable goals report better health and exhibit lower levels of a key stress hormone Blaming oneself is another common response when people are confronted by stressful difficulties the tendency to become highly self-critical in response to stress is noted by a number of theorists Given the way people in our competitive culture tend to disparage the concept of giving up the authors note that it might be better to characterize this coping tactic as "goal adjustment" Albert Ellis called this phenomenon "catastrophic thinking" this causes, aggravates, and perpetuates emotional reactions to stress that are often problematic Aaron Beck argues that negative self-talk can contribute to the development of depressive disorders Ellis and Beck agreed that excessive self-blame can be very unhealthy

Responding to Stress

People's response to stress is complex and multidimensional Building resilience When you groan in reaction to the traffic report your experience a emotional response to stress in this case annoyance and anger When your pulse quickens and your stomach knots up your exhibiting physiological responses to stress When you shout insults at another driver your verbal aggression is behavioural response to stress A person's reaction to stress comes in three levels: Emotional responses, physiological responses and behavioural responses

Positive Effects "what does not kill you can make you stronger" (from stress)

Positive emotions Can be rewarding for those who need stimulation/ challenge Create feelings of gratitude, counting blessings Often creates positive bonds between people Reduce levels of stress hormones and their harmful effects Enhances immune response, emotional well-being, mental health when stressful things happen and handled well... Personal growth and post traumatic growth Reorganize values Re-evaluate priorities Learn new insights Acquire new strengths and skills New coping abilities Enhances self-concept

High stress and impaired task performance

Pressure to perform, disruptive self-consciousness, inappropriate thoughts "choking under pressure" (too much stimulation don't perform well high arousal) Jump to the conclusion to quickly without considering all options Unsystematic, poorly organized review of available options Difficulty suppressing competing thoughts Interferes with memory functions The hippocampus with time shrinks

Additional psychological techniques

Progressive relaxation (let go of tension) Guided imagery Autogenic training (words associated with relaxation) Biofeedback Muscle monitionig meditation/mindfulness Compassion focused therapy (relentless self criticism) Yoga Stress diaries Developing coping skills is like winterizing your car and putting up snow tires when it is best, before, during or after a winter storm?

Effective techniques

Prompting (reminding people of a second appointment) Cutting down on wait times Good doctor/patient communication

Stress, Other Diseases and Immune Functioning

Researchers have uncovered many connections between stress and physical illness Association between the stress and the course of rheumatoid arthritis. Other studies have connected stress to the development of diabetes, herpes, fibromyalgia, and flare-ups of inflammatory bowel syndrome The immune response: is the body's defensive reaction to invasion by bacteria, viral agents, or other foregin substances The immune response works to protect organisms from many forms of disease, a wealth of studies indicate that experimentally induced stress can impair immune functioning in animals Stressors such as crowding, shock, food restriction and restraint reduce various aspects of immune reactivity in laboratory animals Some related stressed to suppress immune activity in humans Those who report high stress are more likely to be infected by viruses Research suggests that exposure to long-term stress can sometimes promote chronic inflammation, inflammation has been recognized as a factor in heart disease. Chronic inflammation contributes to a diverse array of diseases including arthritis, osteoporosis, respiratory diseases, diabetes, Alzhiemer's disease and some types of cancer Chronic inflammation resulting from immune system dysregulation may be another key mechanism underlying the association between stress and a wide variety of diseases

There are costs to ignoring stressors, the way were living in life may damage ourself we need to identify sources of stress

Sources of stress within a role Intrinsic to the tasks at hand Role : ambiguity, conflict, overload, no participation in decision making (play many roles in life boyfriend girlfriend, student) Long term goals (career goals) Short term goals (planning daily and weekly routine) Relationships with others (social interaction, image of self to others) Family/ organizational climate (good or bad relations) How a role fits into the rest of your life (student vs working family, older student) Personality factors (tolerance for ambiguity, health and coping patterns) Type A personality

The Effects of Stress on Physical Health

Stress can have an impact on one's physical health Continuous stress weakens the resistance to diseases and disrupts the functioning of the hormonal and metabolic systems There is a link between stress, physical illness and heart disease hippocampus shrinks with depression

The Effects of Stress on Psychological Functioning

Stress is not inherently bad, you would probably suffocate from boredom if you lived a stress-free existence, stress makes life challenging and interesting. Along the way stress can lead to burnout and other problems

Sizing Up the Link between Stress and Illness

Stress is related to physical health and evidence suggest that stress contributes to the causation of illness, modest relationship between health and stress (moderate association) because isn't just the stressor but how you react with it and coping skills

Stress as an everyday event

Stress tends to spark images of overwhelming traumatic crisis Studies conducted in the aftermath of natural disasters typically find elevated rates of psychological problems and physical illness in the communities affected by these disasters Everyday events such as waiting in line, shopping and even commuting are stressful Concerns about the effects of commuting increase with our stress as the time we spend in our cars simply getting to work increases Routine hassles may have significant harmful effects on mental and physical health can collectively cause great strain

Physiological Responses

The Fight-or-Flight Response: mobilization to action, to do what needs to be done the stress response helps you deal with life's challenges or threats. Your body releases cachacolomines , hormones released by adrenal glands as a result of the hypothalamus and pituitary gland this activates your system. Use this increased oxygen to maximize strength. Without stress we don't have the thing to get us going Walter Cannon: the fight-or-flight response is a physiological reaction to threat in which the autonomic nervous system mobilizes the organism for attacking (fight) or fleeing (flight) an enemy Autonomic nervous system (ANS) controls blood vessels, smooth muscles and glands. The fight-or-flight response is mediated by the sympathetic division of the ANS The physiological arousal associated with the fight-or-flight response is also seen in humans; the automatic reaction is a leftover from humanity's evolutionary past. It's an adaptive response in the animal kingdom where the threat of predators often requires a swift response of fighting or fleeing

The General Adaptation Syndrome

The concept of stress was identified and named by Hans Selye Selye exposed animals to a diverse array of both physical and psychological stressors the patterns of physiological arousal seen in the animals were largely the same regardless of the type of stress Stress reactions are non specific, he maintained that the reactions do not vary according to the specific type of stress encountered Selye formulated an influential theory of stress reactions called the general adaptation syndrome The general adaptation syndrome/ reacting to stress: Is a model of the body's stress response, consisting of three stages: alarm, resistance, and exhaustion

Appraisal: Stress Lies in the Eye of the Beholder

The experience of feeling stressed depends on what events one notices and how one chooses to appraise/ interpret them Events that are stressful for one are not for the other Some people enjoy the excitement of going out on a date with someone new, others find the uncertainty terrifying

Video: health, mind and behaviour

The human mind influences susceptibility to disease The biopsychosocial method treats the whole person as a social context, mental and physical processes interact and affect each other Harmony of mind and body- native Americans health psych study why people become ill, four ways psych and medical problems are related Psychology and medical illness are related: 1. Organic or medical tissue damage may be psychogenic, illness directly psychological state of anxiety or depression 2. Complaints turn out to have no organic basis, physical sources of personal problems, once problems resolved symptoms go away 3. Strengthen or weaken disease, by suppressing/supporting the body's immune system 4. Psychological factors cause illness patterns ie smoking Health psychology try to improve human beings and brings physiological changes immune system Protects the body through antigens, when the immune system functions to fight off infections. To fend of antigens body has devised defenses, the skin, and mucous membranes brain and immune system nerve connection and endocrine system Human fertility implantation, the stress of procedure causes an immune response and less likely to accept a fertilized egg Biofeedback: increase and decrease in heart rate supplies information, train functioning Stress is the pattern of responses an organism makes that disturbs its equilibrium Stressors are part of physical environments ie noise Change is a significant factor of stress, illness and failure, marriage or sudden success. The greater the change the greater the adjustment even positive an attempt to restore equilibrium life change and illness correlation Hans Seyle: stressors in animals, the general adaptation syndrome having three stages (1) alarm reaction stimulates pituitary gland mobilizes body's defenses (2) stage of resistance hormonal secretions counteract stressor (3) stage of exhaustion One person's stress is another's challenge, we evaluate things differently which is a cognitive appraisal Lifestyle is killing us too much stress, smoking AIDS is a common cause of death, a behavioral problem it is spread understand the motivation to change behaviour Depression leads people to get sicker and susceptible to diseases maintain positive outlooks and good lifestyle

Major types of Stress: By Duration (how long)

Theorists have tried to analyze the nature of stressful events and divide them into subtypes. One sensible distinction involves differentiation between acute stressors and chronic stressors

Explicit and implicit social support

There are cultural disparities between the type of social support people prefer Asian's are reluctant to seek support from others and that they assert that social support is not all that helpful to them Explicit social support (overt emotional solace and instrumental aid from others you can see it) *americans evident clearly Implicit social support (the comfort that comes from knowing one has access to close others who will be supportive) nothing happens just know it could happen *collectivist just as useful as explicit social support knowing its there provides comfort Those who perceive a strong sense of connection to their community were more likely to report having both good physical and mental health Two thirds of those who felt they had a strong sense of community belonging reported good physical health and over 80 percent of those with a strong sense of community belonging reported good mental health Social relationships and bonds can be good for mental health Individuals from cultures emphasizing community and interdependence benefiting more from emotional social support than those from cultures where independence is emphasized Greater interactions with strong ties correlated with greater subjective well-being but surprisingly so did with weak ties Our feelings of belongingness and social support are derived from our interaction with close friends and family

Brain-Body Pathways: in response to stress

There are two major pathways along which the brain sends signals to the endocrine system in response to stress, the endocrine system consists of glands located at various sites in the body that secrete chemicals called hormones. The hypothalamus is the brain structure that appears to initiate action along these two pathways The first pathway is routed through the autonomic nervous system. In response to your stress your hypothalamus activates the sympathetic division of the ANS a key part of this activation involves stimulating the central part of the adrenal glands (the adrenal medulla) to release large amounts of catecholamines into the bloodstream The net result of catecholamine elevation is that your body is mobilized for action Heart rate and blood flow increase and more blood is pumped to your brain and muscles, respiration and oxygen consumption speed up which facilitates alertness Digestive processes are inhibited to conserve your energy the pupils of your eyes dilate increasing visual sensitivity The second pathway involves more direct communication between the brain and the endocrine system The hypothalamus sends signals to the master gland of the endocrine system, the pituitary gland. This gland secretes hormone (ACTH) that stimulates the outer part of the adrenal glands to release another important set of hormones corticosteroids (calms down inflammation) These hormones stimulate the release of chemicals that help increase your energy and help inhibit tissue inflammation in case of injury The stress response interferes with neurogenesis because of this the hypothalamus that organizes/remembers/short-long term gets smaller when people are under stress. When people don't have much stress hormones or cortisone in their system neurogenesis begins and an increase in the hippocampus Neurogenesis: the formation of new neurons

Health beliefs and college students

Unrealistically optimistic Issues are more than just knowledge Fail to believe could develop a disorder or suffer a problem as a result of one's own behavior

Roadblocks to seeking treatment

Waiting times for ER and specialist care in Canada How individuals appraise and react to health concerns, seriousness and distriptivenes of symptoms help explain some of the differences among people Delays are critical because early diagnosis may facilitate more effective treatment of many health problems, yet people face procrastination

Emotional Responses

When people are under stress they often react emotionally, studies find relationships between the two

Different "Arenas" or "Baskets" of life : proactive approach and overall lifestyle/health

Work, family, self, community Some people ignore baskets to focus on only one thing causes problems in other baskets Makes you vulnerable to behaviours that will harm you and your family

In approach-avoidance conflict:

a choice must be made about whether to pursue a single goal that has both attractive and unattractive aspect (desire to go forwards and backwards start becoming more fearful as it comes closer) Any time you have to take a risk to pursue some desirable outcome you're likely to find yourself in an approach-avoidance conflict Approach-avoidance conflicts often produce vacillation you go back and forth, beset by indecision you decide to go ahead, then not to

In approach-approach conflict: (least stressful)

a choice must be made between two attractive goals. Two positives/ two things you like but can't do both Ex: you have a free afternoon so should you play tennis or racquetball The approach-approach is the least stressful type of conflict they typically have a reasonable ending whichever way you decide to go Approach-approach conflicts over important issues may sometimes be troublesome If you're torn between two appealing majors you may find the decision making process quite stressful since whichever alternative is not chosen represents a loss of sorts

In avoidance-avoidance conflict:

a choice must be made between two unattractive goal (two miserable choices) Forced to choose between two repelling alternatives Ex: should you continue to collect unemployment cheques or should you take that degrading job at the car wash. Most unpleasant and highly stressful

Potentially stressful objective events:

a major exam, a big date, trouble with one boss, financial setback which may lead to frustration, conflict, change or pressure

Health (World Health Organization)

a physical, mental, and social wellbeing and opens the door to a biopsychosocial model Social and cultural influences Health beliefs Availability and costs of care Benefits and quality of care Threat and perception of symptoms Knowledge about disease Social situation Social class Norms and social interaction

Behaviour and AIDS Aids

acquired immune deficiency syndrome, a disorder in which the immune system is gradually weakened and eventually disabled by the human immunodeficiency virus (HIV) HIV is not equivalent to having AIDS, AIDS is the final stage of HIV infection process, ten years after the original infection AIDS inflicts its harm indirectly by opening the door to other diseases Cases of AIDS have been reported since 1985, the disease continues to increase at an alarming rate HIV is transmitted through person-person contact involving the exchange of bodily fluids, primarily semen and blood, sexual transmission in north america has occoured primarily among gay and bisexual The more sexual partners that a person has, the higher the risk that the person will be exposed to the virus. People can reduce their risk by having sexual contacts with fewer partners and by using condoms to control the exchange of semen

Sing Lin

age people retired, those who retire at 50 live to 86, those who retire at 65 live to 66.8. One loses 2 years of life span on average for every one year one works beyond age 55 (one loses 2 years of life span) People who retire early plan ahead live long and prosper. people who retire they keep busy but do so depending on how they feel that week or that time, people who stay on the job work the same as always pretend they are 30 and beat themselves up which wears them down and leads to death age at retirement and average age at death

When you view an event as stressful you are likely to make a secondary appraisal

an evaluation of your coping resources and options for dealing with the stress Primary appraisal would determine whether you saw an upcoming psychology exam as stressful. Your secondary appraisal would determine how stressful the exam appeared in light of your assessment of your ability to deal with the event (figure out what to do about it skills and coping mechanisms) Some people are more prone than others to feeling threatened by life's decisions

Emotional response:

annoyance, anger, anxiety, fear, dejection, grief

Classification of stressors by complexity Stressor:

another word for environmental demands (all stressors are biological ie. a warm day) and impact our behavior/biology some also impact us on a..... Biological, psychological, interpersonal (things happen between people), socio-cultural (when society changes ie new technology and when you as an individual change as a relationship to society) each change there is a dramatic change on each level

Conflict come in three types which were originated by Kurt Lewin and investigated by Neal Miller these basic types:

approach-approach, avoidance-avoidance and approach-avoidance

Life changes:

are any substantial alterations in one's living circumstances that require readjustment Developed Social Readjustment Rating Scale (SRRS) to measure life change as a form of stress The scale assigns numerical values to 43 major life events, which reflect magnitude of the readjustment required by each change The total is an index of the amount of change-related stress the person has recently experienced Shown that people with higher scores tend to be more vulnerable to many kinds of physical illness and to many types of psychological problems the more change you have the more likely you are to get sick healthy vs sick (death of spouse, etc big changes)

Defensive Coping Defence Mechanisms:

are largely unconscious reactions that protect a person from unpleasant emotions such as anxiety and guilt Pretend challenges faced are not serious when they really are, denying reality Repression, projection, displacement, reaction formation, regression, rationalization, identification, sublimation The main purpose of defence mechanisms is to shield individuals from the unpleasant emotions so often elicited by stress They accomplish this purpose through self-deception, distorting reality so it doesn't appear so threatening, largely unconscious Defensive coping is less than optimal because avoidance and wishful thinking rarely solve personal problems depressive realism see the world for what it really is (can be of value and live longer) "Positive illusion" can sometimes be adaptive for mental health and can help people create through defensive coping deal with life difficulties there is an "optimal margin of illusion" extreme distortions of reality are maladaptive but small illusions can be beneficial

Chronic stressors:

are threatening events that have a relatively long duration and readily apparent time limit (long duration with no clear endpoint) Ex: persistent financial strains produced by card debts, looking after a family member with severe disabilities

Acute stressors:

are threatening events that have a relatively short duration and a clear endpoint Ex: dealing with a challenge of a major exam/ next midterm (specific)

Physiological response:

autonomic arousal, hormonal fluctuations

Inverted U hypothesis

because when performance is plotted as a function of arousal the resulting graphs approximate an upside-down U The level of arousal at which performance peaks is characterized as the optimal level of arousal for a task The optimal arousal level appears to depend on the complexity of the task at hand. As a task becomes more complex, the optimal level of arousal (for peak performance) tends to decrease A fairly high level of arousal should be optimal on simple tasks Performance should peak at a lower level of arousal on complex tasks Sensory deprivation chamber (measuring brain activity) Understimulation: coping strategy, increase life challenges, take on new responsibilities, boredom, fatigue (self-stimulate bc no excitment) Optimum stimulation: where you perform best and stay happy and healthy, creative, rational problem-solving satisfaction (enough stimulation) Overstimulation: set priorities, decreases stress intake, irrational problem solving, exhaustion, illness, low self-esteem (too much to deal with)

Behavioural response:

coping efforts, blaming oneself, solving problems

Adaptive Coping:

how do you adapt to things Maladaptive coping: you do behaviours that help you get through something but may cause you harm in the long run eg cigarette to calm down get you through short term but harm long term

Broaden-and-build theory of positive emotions

if you handle things in a creative way it Broadens scope of attention increasing creativity and flexibility in problem solving Undo negative effects of lingering effects of negative emotions Promote rewarding social interactions

Routes by which stress may produce disease Health behaviour effects:

decreased compliance, increased delay in seeking care, obscured symptom profile, decreased likelihood of seeking care

Adhering to Medical Advice - compliance

doctor/patient relationship doctor/patient communication Specific treatment or instructions Patients social support system Patients health beliefs 1 in 5 who get a prescription don't take it if its difficult people might not do it 70 or 90 percent diagnosed with high blood pressure do not comply

Proactive coping:

doing things in advance to get ready for life's challenges

Routes by which stress may produce disease Physiological effects:

elevated lipids, elevated blood pressure, decreased immunity, increased hormonal activity

Four major types of stress:

frustration, conflict, change and pressure

The biopsychosocial model:

holds that physical illness (health) is caused by a complex interaction of biological (environmental factors, genetic predisposition) psychological (stress, personality) and sociocultural factors (social support, education) Part of health psychology Interact to create health and illness, stress is an example of how these factors interact

Post-Traumatic Stress Disorder

involves enduring psychological disturbance attributed to the experience of a major traumatic event (if it sticks around) Continuously aroused, avoid things, numb emotions, flashbacks Higher incidence of physical disorders such as chronic musculoskeletal disorders and obedience Post-traumatic stress disorder is increasingly associated with people in other front-line occupations such as police officers, firefighters, ambulance attendants PTSD and other serious stress reactions are not restricted solely to individuals who work in these types of occupations it can happen to anyone who suffers with trauma it has been associated with other types of events including rape, assuault, witnessing and death

Burnout

involves physical and emotional exhaustion, cynicism, and a lowered sense of self-efficacy that can be brought on gradually by chronic work-related stress Negative attitudes towards life and see everything as useless Exhaustion includes chronic fatigue, weakness, and low energy Cynicism is manifested in highly negative attitudes towards oneself, one's work and life in general Reduced self-efficacy involves declining feelings of competence at work which gives way to helplessness Burnout is associated with increased absenteeism and reduced productivity at work Canadians with high-stress jobs were much more likely to take disability days off work The workplace causes burnout struggling with interpersonal conflicts, lack of control over work responsibilities and outcomes, and inadequate recognition for one's work Too many demands or work hours, fear of job loss, poor interpersonal relationships at work, risk of injury. These high levels of stress have been linked to psychopathology

Hardiness:

is a constellation of attitudes, beliefs, and behavioural tendencies that consists of three components: commitment, control and challenge Characterized by high levels of three traits all beginning with the letter C, control, challenge and commitment They approach difficult task as challenges, they view work as important and are committed , they saw themselves as in control of their time and efforts

Health psychology:

is concerned with how psychosocial factors relate to the promotion and maintenance of health and with the causation, prevention, and treatment of illness

Frustration:

is experienced whenever the pursuit of some goal is thwarted You experience frustration whenever you want something and you can't have it, this can elicit anger and aggression

Type B personality

is marked by relatively relaxed, patient, easygoing, amicable behaviour. Type B's are less hurried, less competitive, and less easily angered than type A's Focusing on anger and hostility in Type A personality, hostility may be the crucial toxic element in the Type A syndrome

Primary appraisal:

is the initial evaluation of whether an event is irrelevant to you, relevant but not threatening or stressful

Self empowerment strategies:

learn new skills, come up with new strategies to cope, talk to others, problem solving, get information Swiss cheese approach: one can find way reducing ways of negative impact, cut holes out of the problem (getting fired get line of credit to reduce impact) Set priorities, do what needs to be done first and pace yourself Cognitive coping strategies, using insights to put feelings in perspective and accept change

Neuroticism

may make people overly prone to interpret events as stressful and overly prone to interpret unpleasant sensations as symptoms of illness, thus inflating the correlation between stress and illness Strength of the relationship between stress and health is modest typically falls in the 0.20s and 0.30s Stress is not an irresistible force that produces inevitable effects on health Stress is one factor operating in a complex network of biopsychosocial determinants of health Other factors include one's genetic endowment, exposure to infectious agents, environmental toxins, nutrition, exercise, alcohol, and drug use, smoking use of medical care A number of moderator variables can lessen the impact of stress on physical and mental health: social support, optimism and conscientiousness

Ulcers in "Executive Monkeys"

monkeys put in a standard type of situation that they couldn't get out of restrictive chair and shocks If monkey presses leaver avoids getting electric shock Always having to wonder when it's time to press the lever, over-responding/adapting to the situation killed the monkey (uncertainty no control) IV- a lever that doesn't do anything how do we build resilience come up with a better plan to make ourselves stronger executive has responsibilities but control less control moving down the ladder People who are good at coping stuff get promoted, called cream rises to the top theory pressure to perform e.g.

Alarm reaction:

occurs when an organism first recognizes the existence of a threat (defensive forces are mobilized) Physiological arousal occurs as the body musters its resources to combat the challenge. Selye's alarm reaction is essentially the fight-or-flight response originally described by Cannon Physiological changes stabilize as coping efforts get under way. Physiological arousal continues to be higher than normal, although it may level off somewhat as the organism becomes accustomed to the threat Stress continues over a substantial period of time, the organism may enter the third stage, the stage of exhaustion The body's resources for fighting stress are limited the organism would experience hormonal exhaustion, chronic overactivation of the stress response can have damaging physiological effects on a variety of organ system These harmful physiological effects can lead to a "disease of adaptation" Resistance stage: body adapts to stressors Exhaustion : stressors negates body's coping mechanisms

Internal conflict Conflict:

occurs when two or more incompatible motivations or behavioural impulses compete for expression Sigmund Freud proposed that internal conflicts generates considerable psychological stress

Reactive coping:

once bad things happen how to deal with those that you didn't expect

Subjective cognitive appraisal:

personalized perceptions of threat, which are influenced by familiarity with the events its controllability and predictability (what you can do about it)

High arousal:

range of attention narrows but is more intense, more difficult shifting attention May need to reduce stimulation to perform well on a task May perform simple tasks well but have difficulties with complex tasks (difficulties suppressing impulsivity to let the executive function organize and coordinate response) hard to focus only on a smaller number of factors in the environment

Social support

refers to various types of aid and emotional sustenance provided by members of one's social networks (a moderator of stress) 1. Instrumental support: a kind of support that helps you get the job done, shares different skills together 2. Self-social support: believe in yourself 3. Social-emotional support: at home Help in gaining perspective, guidance in problem solving, practical help, a haven for rest and recuperation, a reference and control group, achievement of emotional mastery Positive correlations between high social support and greater immune functioning Loneliness and social isolation was found to predict reduced immune responding Social isolation to poor health and increased mortality Social support is greatly favourably related to physical health The importance of social support and familiar comfortable surrounding is especially true for those with long-term illnesses The positive effects of important, supportive relationships extend to the effects of the quality of a marriage, and health outcomes (morality) Positive marriages are associated with a range of positive health indicators People suffering from depression and low self esteem are sensitive to the absence of social support Self-esteem and relational social support is complex, those with low self-esteem may need and want positive social support from their relationship partners because they doubt their own value, they may resist and/or distort positive supportive feedback from their partners and may behave in ways that serve to alienate those partners Providing positive, supportive feedback to relationship partner with low self esteem may be difficult When providers offer support that validates LSE's negative thoughts and feelings (and supports their self-verification and mood regulation goals such interactions appear to be more successful

Indulging Oneself

stimulated, fight or flight response Stress sometimes leads to reduced impulse control or self-indulgence, mobilization to take action on fight of flight to calm oneself down or pleasurable Many people engage in unwise patterns of eating, drinking, spending money Stress related to negative life events associated with youth problem gambelling Another example of self-indulgence as coping strategy is stress-induced shopping. Stress, materialism,and compulsive shopping Stress increases compulsive consumption and that this coping strategy is particularly common among those who are highly materialistic When the going gets tough the materialistic go shopping Internet addiction: excessive gaming, preoccupation with sexual content or obsessive socializing all three subtypes exhibit Excessive time online Anger and depression when thwarted from being online An escalating need for better equipment and connections Adverse consequences ie. arguments and lying about internet use, social isolation, and reductions in academic or work performance (not rare) Internet addiction is associated with increased levels of anxiety, depression and alcohol use

Another definition of stress:

stress is the nonspecific response of the body to any demand placed upon it (Hans Selye) Saw many different diseases and made a simple observation, what's remarkable is many people have similarities , we say someone isn't looking well and wondered why there is a common way people look when they have illnesses? The body has a general way of reacting to stressors (general adaptation response) Adaptations that help us survive everyday life, fight or flight reaction getting this delt with, help deal with life challenges with stress response mobilization to action

Low arousal

tend to have a wide range of attention and may readily shift attention May need stimulation to perform well at a task May perform complex tasks well but have difficulties with simple tasks Not enough challenge when relaxed our mind wanders, you need stimulation to get a task done (hard to get simple tasks done) but complex tasks you might get done well in quiet times

Pressure Biological clocks:

time people look good, are attracted to each other can only have babies up to a certain age Social expectations - have to get married Pressure to perform Sometimes the pressure comes from a mismatch between what we have to or want to do and the time available Severely time-stressed had increased between 1992-1998 The more time pressure or time crunch we feel, the less we are able to get a good night's sleep Pressure: involves expectations or demands that one behave in a certain way You are under pressure to perform when you're expected to execute tasks and responsibilities quickly, efficiently and successfully Pressure to conform to others' expectations are also common in our lives Pressure has turned out to be more strongly related to measures of mental health than the SRRS and other established measures of stress and researchers have investigated the link between these are other facets of stress and heart disease

Constructive Coping:

to refer to relatively healthful efforts that people make to deal with stressful events, no strategy of coping can guarantee a successful outcome Even the healthiest coping responses may turn out to be ineffective in some circumstances The concept of constructive coping is simply meant to connote a healthful, positive approach without promising success What makes coping strategies constructive? 1. Constructive coping involves confronting problems directly. It is task-relevant and action-oriented it entails a conscious effort to rationally evaluate your options so that you can try to solve your problems 2. Constructive coping is based on reasonably realistic appraisals of your stress and coping resources a little self-deception may sometimes be adaptive but excessive self-deception and highly unrealistic negative thinking are not 3. Constructive coping involves learning to recognize and regulate, potentially disruptive emotional reactions to stress 4. Making efforts to ensure your body is not especially vulnerable to possible damaging effects of stress


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