Chapter 3 book

distress

Stress that is unpleasant and threatening

stress response

The resulting physical and psychological reactions to stressors are known as

SAM

(sympatho-adreno-medullary) system

Six Additional Stress Resources Exercise

Exercising and keeping fit help minimize anxiety and depression, which are associated with stress. Exercise also helps relieve muscle tension; improves cardiovascular efficiency; and increases strength, flexibility, and stamina. Those who do not find time for exercise will have to find time for illness. —Edward Smith-Stanley

Prejudice and discrimination as chronic stressors

Research has found that the chronic stress resulting from prejudice and discrimination is linked to serious physical and mental problems, including being at a higher risk of heart disease, inflammation, substance abuse, and suicide

social support

Another effective and frequently overlooked resource for stress management is social support. When we are faced with stressful circumstances, our friends and family often help us take care of our health, listen, hold our hands, make us feel important, and provide stability to offset the changes in our lives. This support can help offset the stressful effects of chronic illness, pregnancy, physical abuse, job loss, and work overload. People who have greater social support also experience better health outcomes, including greater psychological well‐being, greater physical well‐being, faster recovery from illness, and a longer life expectancy (Cherry et al., 2015; Diener & Tay, 2015; Martínez‐Hernáez et al., 2016). Even a single close childhood friendship seems to protect children in lower socioeconomic circumstances (which is an ongoing stressor) from several negative psychological risk factors (Graber et al., 2015). These findings may help explain why married people live longer than unmarried people (Liu, 2009), and why a married person with cancer is 20% less likely to die from the disease than an unmarried person (Aizer et al., 2013). So what is the important take‐home message from this emphasis on social support? Don't be afraid to offer help and support to others—or to ask for the same for yourself!

stress management

As noted at the beginning of this chapter, stress is a normal, and necessary, part of our lives. Therefore, stress management is the goal—not stress elimination. Although our initial, bodily responses to stress are largely controlled by nonconscious, autonomic processes, our higher brain functions can help us avoid the serious damage from chronic overarousal. The key is to consciously recognize when we are overstressed and then to choose resources that activate our parasympathetic, relaxation response. In this section, we'll first discuss the role of cognitive appraisal in coping with stress. Then we'll explore how personality and individual differences affect our coping responses. Finally, we'll present several important resources for healthy living and stress management.

What Does a Health Psychologist Do?

As researchers, health psychologists are particularly interested in how changes in behavior can improve health outcomes (Anisman, 2016; Straub, 2014). They also emphasize the relationship between stress and the immune system. As we discovered earlier, a normally functioning immune system helps defend against disease. On the other hand, a suppressed immune system leaves the body susceptible to a number of illnesses. As practitioners, health psychologists can work as independent clinicians or as consultants alongside physicians, physical and occupational therapists, and other health care workers. The goal of health psychologists is to reduce psychological distress and unhealthy behaviors. They also help patients and families make critical decisions and prepare psychologically for surgery or other treatment. Health psychologists have become so involved with health and illness that medical centers are one of their major employers (Considering a Career, 2011). Health psychologists also educate the public about illness prevention and health maintenance. For example, they provide public information about the effects of stress, smoking, alcohol, lack of exercise, and other health issues. Tobacco use endangers both smokers and those who breathe secondhand smoke, so it's not surprising that health psychologists are concerned with preventing smoking and getting those who already smoke to stop. Did you know that according to the U.S. Department of Health and Human Services, smoking has killed 10 times the number of Americans who died in all our nation's wars combined (Sebelius, 2014)? Thanks in large part to comprehensive mass media campaigns, smoke‐free policies, restrictions on underage access to tobacco, and large price increases, adult smoking rates have fallen from about 43% in 1965 to about 18% in 2014. Unfortunately, cigarette smoking remains as the leading cause of preventable death worldwide (Centers for Disease Control, 2016).

mindfulness‐based stress reduction (MBSR)

As we've just seen, various cognitive appraisal techniques and personality and individual differences have significant effects on our stress management. In this section, we'll provide specific, evidence‐based resources for stress management. Perhaps the most researched approach comes from the recent mindfulness‐based stress reduction (MBSR) programs, which are based on developing a state of consciousness that attends to ongoing events in a receptive, non‐judgmental way. The practice of MBSR has proven to be particularly effective in managing stress and treating mood disturbances, and it's even been linked to positive, and perhaps permanent cell and brain changes (Creswell et al., 2016; Felleman et al., 2016; Mallya & Fiocco, 2016). Did you know that mindfulness training can also improve your grades?

Cardiovascular Disorders

Cardiovascular disorders contribute to over half of all deaths in the United States (American Heart Association, 2013). Understandably, health psychologists are concerned because stress is a major contributor to these deaths (Marchant, 2016; Orth‐Gomér et al., 2015; Taylor‐Clift et al., 2016). Heart disease is a general term for all disorders that eventually affect the heart muscle and lead to heart failure. Coronary heart disease occurs when the walls of the coronary arteries thicken, reducing or blocking the blood supply to the heart. Symptoms of such disease include angina (chest pain due to insufficient blood supply to the heart) and heart attack (death of heart muscle tissue). Recall that one of the major brain and nervous system autonomic reactions to stress is the release of epinephrine (adrenaline) and cortisol into the bloodstream. These hormones increase heart rate and release fat and glucose from the body's stores to give muscles a readily available source of energy. If no physical fight‐flight‐freeze action is taken (and this is most likely the case in our modern lives), the fat that was released into the bloodstream is not burned as fuel. Instead, it may adhere to the walls of blood vessels. These fatty deposits are a major cause of blood‐supply blockage, which, in turn, causes heart attacks. Of course, the stress‐related buildup of fat in our arteries is not the only risk factor associated with heart disease. Other factors include smoking, obesity, a high‐fat diet, and lack of exercise

external locus of control

Conversely, people with an external locus of control believe that chance or outside forces beyond their control determine their fate. Therefore, they tend to feel powerless to change their circumstances, are less likely to make effective and positive changes, and are more likely to experience high levels of stress

f you have a friend or loved one with PTSD, it may feel like you're walking through a minefield when you're attempting to comfort and help them. What do the experts suggest that you say (or NOT say)? Here are a few general tips:

Don't trivialize the disease. Like cancer or heart disease, PTSD, and its associated anxiety and depression, is a critical, life‐threatening illness. Asking someone, "What do you have to be depressed about?" is akin to asking cancer patients why they have cancer, or why they don't just smile and exercise more? 2. Don't be a cheerleader or a Mr. or Ms. Fix‐It. You can't pep‐talk someone out of PTSD, and offering cheap advice or solutions is the best way to ensure that you'll be the last person he or she will turn to for help. What Can You Do? Educate yourself. Your psychology instructor, college library, book stores, and the Internet all provide a wealth of information. Be Rogerian. Carl Rogers' four important qualities of communication (empathy, unconditional positive regard, genuineness, and active listening discussed in Chapter 11) are probably the best, and safest, approaches for any situation—including talking with someone who's suffering from PTSD. Get help! The most dangerous problem associated with PTSD, and its commonly associated serious depression, is the high risk of suicide. If a friend or loved one mentions suicide, or if you believe he or she is considering it, get professional help fast! Consider calling the police for emergency intervention, the person's trusted friend or family member, or the toll‐free 7/24 hotline 1‐800‐SUICIDE.

key parts of PTSD

EY CHARACTERISTICS OF PTSD Direct exposure to trauma through personal experience, witnessing it, or discovering that it happened to others. Also direct, ongoing exposure to traumatic events (e.g., first responders). Recurrent, intrusive symptoms, including thoughts, feelings, memories and bad dreams. Also, re‐experiencing the trauma over and over through flashbacks. Avoidance symptoms, such as feeling emotionally numb, losing interest in previously enjoyable activities, avoiding memories of the trauma and/or stimuli associated with the traumatic event. Chronic heightened arousal and reactivity, including irritability, being easily startled, sleep disturbances, angry outbursts, and reckless/self‐destructive behaviors. Sadly, one of the most dangerous problems associated with PTSD is the increased risk for suicide. Did you know that the number of suicides committed by young male veterans under the age of 30 jumped by 44% between 2009 and 2011, while the rate for female vets increased by 11% in the same time period? The precise cause for this astronomically high and climbing jump in suicides is unknown, but experts point to PTSD, along with combat injuries, and the difficulties of readjusting to civilian life PTSD is not a new problem. During the Industrial Revolution, workers who survived horrific railroad accidents sometimes developed a condition very similar to PTSD. It was called "railway spine" because experts thought the problem resulted from a twisting or concussion of the spine. Later, doctors working with combat veterans referred to the disorder as "shell shock" because they believed it was a response to the physical concussion caused by exploding artillery. Today, we know that PTSD is caused by exposure to extraordinary stress

Coping with Job and Technostress

Experts are suggesting that we can (and must) control technology and its impact on our lives. Admittedly, we all find the new technologies convenient and useful. But how can we control technostress? First, evaluate each new technology on its usefulness for you and your lifestyle. It isn't a yes or no, "technophobe" or "technophile," choice. If something works for you, invest the energy to adopt it. Second, establish clear boundaries. Technology came into the world with an implied promise of a better and more productive life. But, for many, the servant has become the master. Like any healthy relationship, our technology interactions should be based on moderation and balance (Ashton, 2013). In addition to evaluating technology on its personal usefulness and establishing clear boundaries, you can score your past, current, and potential future careers on several additional factors in job‐related stress

job stress

For many people, one of their most pressing concerns is job stress, which can result from unemployment, job change, and/or worries about job performance. At its worst, it can even contribute to suicide (Adams, 2015; Cartwright & Cooper, 2014; Rees et al., 2015). Studies of first responders and other high‐risk professions, such as police officers, firefighters, paramedics, military and medical personnel, have found an elevated risk of suicide, suicidal thoughts and behaviors, and posttraumatic stress disorder (PTSD) (Carpenter et al., 2015; Stanley et al., 2016; Tei et al., 2015). In addition, studies have found that job stress is higher in occupations that have little job security, and make great demands on performance and concentration, with little or no allowances for creativity or opportunity for advancement

Approach-approach A diagram shows two boxes with plus signs depicting approach-approach conflicts.

Forced choice between two options, both of which have equally desirable characteristics Generally easiest and least stressful conflict to resolve have equally desirable characteristics Generally easiest and least stressful conflict to resolve Two equally desirable job offers, but you must choose one of them You make a pro/con list and/or "flip a coin"

Avoidance-avoidance + -

Forced choice between two options, both of which have equally undesirable characteristics Difficult, stressful conflict, generally resolved with a long delay and considerable denial Two equally undesirable options—bad job or no job—and you must choose one of them because you're broke You make a pro/con list and/or "flip a coin" and then delay the decision as long as possible, hoping for additional job offers

Approach-avoidance - -

Forced choice involving one option with equally desirable and undesirable characteristics Moderately difficult choice, often resolved with a partial approach One high-salary job offer that requires you to relocate to an undesirable location away from all your friends and family You make a pro/con list and/or "flip a coin;" if you take the job you decide to only live in the new location for a limited time (a partial approach)

defense mechanisms

Freud believed we commonly turn to another type of cognitive appraisal and response, known as defense mechanisms, in which we unconsciously distort reality to protect our egos and to avoid anxiety (see Chapter 11). These defense mechanisms can sometimes act as a beneficial type of emotion‐focused coping. For example, when you're really angry at your boss and realize that you can't safely express that anger, you may take out your frustration by aggressively hitting a punching bag at the gym. This would be a healthy use of defense mechanisms. But if taken too far they can be destructive. If we fail to get the promotion, and then resort to elaborate excuses (rationalizations) for our failure, it may block us from seeing a situation more clearly and realistically, which in turn can prevent us from developing valuable skills. In short, occasional use of defense mechanisms can be beneficial, as long as it's not excessive and does not distort reality

positive affect

Have you ever wondered why some people survive in the face of great stress (personal tragedies, demanding jobs, or an abusive home life) while others do not? One answer may be that these "survivors" have a unique trait called positive affect, meaning they experience and express positive emotions, including feelings of happiness, joy, enthusiasm, and contentment. Interestingly, people who are high in positive affect also experience fewer colds and auto accidents, as well as better sleep, and an enhanced quality of life (Anisman, 2016; Pollock et al., 2016; Tavernier et al., 2016). Positive states are also sometimes associated with longer life expectancy. One study of 600 patients with heart disease found that those with more positive attitudes were less likely to die during a five‐year follow‐up period (Hoogwegt et al., 2013). More specifically, only 9% of those with positive attitudes died five years later, compared to 16.5% of those with less positive attitudes. This study provides intriguing evidence for the mind‐body link. Positive affect is also associated with a lower risk of mortality in patients with diabetes, which is a leading cause of death in the United States (Cohn et al., 2014; Moskowitz et al., 2008). Can you see how having a positive affect is closely associated with a good sense of humor? Humor is one of the best methods you can use to reduce stress. The ability to laugh at oneself and at life's inevitable ups and downs allows us to relax and gain a broader perspective

SEVEN IMPORTANT TIPS FOR COPING WITH CRISIS

If you have experienced a traumatic event, recognize your feelings about the situation, and talk to others about your fears. Know that these feelings are a normal response to an abnormal situation. If you know someone who has been traumatized, be willing to patiently listen to their account of the event, pay attention to their feelings, and encourage them to seek counseling, if necessary. Be patient and kind to yourself and others. It's natural to feel anxious, helpless and/or frustrated, but give yourself a break. Also, tempers are short in times of crisis, and others may be feeling as much stress as you. Recognize normal crisis reactions, such as sleep disturbances and nightmares, withdrawal, reversion to childhood behaviors, and trouble focusing on work or school. Be mindful of your time. Feel free to say "NO" to others. Limit your news watching. Take time with your children, spouse, life partner, friends, and coworkers to do something you enjoy. Get plenty of sleep and avoid alcohol and other drugs. We all need a good night's sleep, especially during times of crisis. Alcohol and other drugs interfere with sleep and good decision making. Study and adopt stress management skills, such as the ones discussed in this chapter.

technostress

If you're not suffering from overwork, are you hassled and stressed by the ever‐changing technology at your workplace? Do the expensive machines your employers install to "aid productivity" create stress‐related problems instead? Does technology in your home allow you to accomplish several things simultaneously—talking on your cell phone, checking and responding to emails, warming your dinner in the microwave, doing a load of laundry—yet you end up feeling irritable and exhausted? If so, you may be suffering from the well‐documented, ill‐effects of technostress, a feeling of anxiety or mental pressure from overexposure or involvement with technology (Joo et al., 2016; Maier et al., 2015; Tarafdar et al., 2015). Although technology is often described as a way of bringing people together, how often have you noticed busy executives frantically checking their e‐mail while on vacation? It's even common to see families eating dinners at restaurants with their children playing video games or text messaging, and the parents loudly talking on separate cell phones. In fact, simply placing a cell phone on the table between two people—even if no one ever picks it up—leads to lower levels of closeness, connection, and meaning in their conversation

chronic stress

In contrast to short‐term stress, ongoing wars, a bad marriage, poor working conditions, poverty, and/or prejudice and discrimination (discussed in Figure 3.2), can all be significant sources of chronic stress (Arbona & Jimenez, 2014; Chaby et al., 2015; Vliegenthart et al., 2016). In our private lives, chronic stressors like child and spousal abuse, alcoholism, and money problems can all place severe stress on a family (Fan et al., 2015; Liang, 2015; Simons et al., 2016). Surprisingly, chronic stress can even suppress sexual desire and damage testicular cells in male rats (Hou et al., 2014). In addition, stress from persistent environmental noise is associated with negative changes in the brain and hormone levels (Fouladi et al., 2012)

psychoneuroimmunology

Knowledge that psychological factors have considerable control over infectious diseases has upset the long‐held assumption in biology and medicine that these diseases are strictly physical. The clinical and theoretical implications are so important that a new interdisciplinary field, called psychoneuroimmunology, has emerged. It studies the effects of psychological and other factors on the immune system. As you'll discover in Chapter 7, short‐term stress can solidify our memories for highly emotional, "flashbulb" events. But it also can interfere with the retrieval of existing memories, the laying down of new memories, and general information processing (Banks et al., 2015; Paul et al., 2016; Rubin et al., 2016). This interference with cognitive functioning helps explain why you may forget important information during a big exam, and why people may become dangerously confused during a fire and be unable to find the fire exit. The good news is that once the cortisol washes out, memory performance generally returns to normal levels. Can you see why scientists believe our increased memories for emotional events may have evolved to help us remember what to avoid or protect in the future?

Cognitive Appraisal and Stress Management

Research suggests that when facing a serious stressor, we begin with a primary appraisal process to evaluate the threat, and decide whether it's harmless or potentially harmful. Next, during secondary appraisal, we assess our available and potential resources for coping with the stress. Then, we generally choose either emotion‐ or problem‐focused methods of coping. When attempting to resolve complex stressors, or a stressful situation that is in flux, we often combine both emotion‐ and problem‐focused approaches.

To score yourself on the Social Readjustment Rating Scale (SRRS), add up the "life change units" for all life events you have experienced during the last year and compare your score with the following standards: 0-150 = No significant problems; 150-199 = Mild life crisis (33% chance of illness); 200-299 = Moderate life crisis (50% chance of illness); 300 and above = Major life crisis (80% chance of illness).

LIFE EVENTS LIFE CHANGE UNITS Death of spouse 100 Divorce 73 Marital separation 65 Jail term 63 Death of a close family member 63 Personal injury or illness 53 Marriage 50 Fired at work 47 Marital reconciliation 45 Retirement 45 Change in health of family member 44 Pregnancy 40 Sex difficulties 39 Gain of a new family member 39 Business readjustment 39 Change in financial state 38 Death of a close friend 37 Change to different line of work 36 Change in number of arguments with spouse 35 Mortgage or loan for major purchase 31 Foreclosure on mortgage or loan 30 Change in responsibilities at work 29 Son or daughter leaving home 29 Trouble with in-laws 29 Outstanding personal achievement 28 Spouse begins or stops work 26 Begin or end school 26 Change in living conditions 25 Revision of personal habits 24 Trouble with boss 23 Change in work hours or conditions 20 Change in residence 20 Change in schools 20 Change in recreation 19 Change in church activities 19 Change in social activities 18 Mortgage or loan for lesser purchase (car, major appliance) 17 Change in sleeping habits 16 Change in number of family get-togethers 15 Change in eating habits 15 Vacation 13 Christmas 12 Minor violations of the law 11

Material resources

Money increases the number of options available for eliminating sources of stress or reducing the effects of stress. When faced with the minor hassles of everyday living, acute or chronic stressors, or major catastrophes, people with more money, and the skills to effectively use it generally fare better. They experience less overall stress, and can "buy" more resources to help them cope with what stressors they do have.

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Most of Selye's ideas about the GAS pattern have proven to be correct. For example, studies have found that the primary behavioral response to stress by both men and women is to fight or flee-the classic "fight or flight" response. However, this two option response does not include situations in which we become immobile and "freeze" in the face of stress. Therefore, many researchers have now replaced the previous label of "fight or flight" with a new three option response, called fight‐flight‐freeze (Corr & Cooper, 2016; Friedman, 2015; Maack et al., 2015). Before going on, it's important to note that different stressors evoke different responses and that people vary widely in their reactions to them. For example, women are more likely to "tend and befriend" (Cardoso et al., 2013; Taylor, 2006, 2012; von Dawans et al., 2012). This means that when under stress women more often take care of themselves and their children (tending), while also forming strong social bonds with others (befriending). Interestingly, other research has found that after being administered oxytocin, the so‐called "love hormone" that increases bonding, attachment, and empathy, both men and women participants showed enhanced compassion toward women but not toward men (Palgi et al., 2015). These researchers explain their results by suggesting that the females' "tend and befriend" behaviors may have evolved from a need to help vulnerable individuals of both sexes, rather than being a result of true gender differences. What is Selye's most important take‐home message? Our bodies are relatively well designed for temporary stress but poorly equipped for prolonged stress. The same biological processes that are adaptive in the short run, such as the fight‐flight‐freeze response, can be hazardous in the long run (Papathanasiou et al., 2015; Russell et al., 2014).

Posttraumatic Stress Disorder (PTSD)

One of the most powerful examples of the effects of severe stress is posttraumatic stress disorder (PTSD) (American Psychiatric Association, 2013; Anisman, 2016; Levine, 2015). PTSD is a long‐lasting, trauma and stressor‐related disorder that overwhelms an individual's ability to cope. It can occur in both adults and children. Have you ever been in a serious car accident or been the victim of a violent crime? According to the National Institute of Mental Health (NIMH) (2014), it's natural to feel afraid when in danger. But for some people suffering from PTSD, the normal fight‐flight‐freeze response is modified or damaged. This change helps explain why people with PTSD continue to experience extreme stress and fear, even when they're no longer in danger. Research shows that approximately 40% of all children and teens will experience a traumatic stressor and that the lifetime prevalence for trauma is between 50 to 90% (Brown et al., 2013; Cohen et al., 2014). However, the vast majority will not go on to develop PTSD. PTSD's essential feature is the development of characteristic symptoms (Table 3.2) following exposure to one or more traumatic events (American Psychiatric Association, 2013). These symptoms may continue for months or even years after the event. Unfortunately, some victims of PTSD turn to alcohol and other drugs to cope, which generally compounds the problem

Social skills

People who acquire social skills (such as knowing appropriate behaviors for certain situations, having conversation starters up their sleeves, and expressing themselves well) suffer less anxiety than people who do not. Social skills not only help us interact with others but also communicate our needs and desires, enlist help when we need it, and decrease hostility in tense situations.

internal locus of control

Perhaps one of the most important personal resources for stress management is a sense of personal control. People who believe they are the "masters of their own destiny" have what is known as an internal locus of control. Believing they control their own fate, they tend to make more effective decisions and healthier lifestyle choices, are more likely to follow treatment programs, and more often find ways to positively cope with a situation.

burnout

Persistent hassles, among other factors, can lead to a form of physical, mental, and emotional exhaustion known as burnout (Cranley et al., 2016; Guveli et al., 2015; Zysberg et al., 2016). This is particularly true for some people in chronically stressful professions, such as firefighters, police officers, doctors, and nurses. Their exhaustion and "burnout" then lead to more work absences, reduced productivity, and increased risk of illness. Some authorities believe hassles can be more significant than major life events in creating stress (K Some authorities believe hassles can be more significant than major life events in creating stress (Kubiak et al., 2008; Stefanek et al., 2012). Divorce is extremely stressful, but it may be so because of the increased number of hassles it brings—changes in finances, child‐care arrangements, longer working hours, and so on.

homeostasis

SAM (sympatho-adreno-medullary) system and HPA (hypothalamic-pituitary-adrenocortical) axis then work together to increase our arousal and energy levels to deal with the stress (Anisman, 2016; Dieleman et al., 2016; Garrett, 2015). Once the stress is resolved, these systems turn off, and our bodies return to normal, baseline functioning

eustress

So far in our discussion, we've focused primarily on the harmful, negative side of stress, but there are also some positive aspects. Our bodies are nearly always in some state of stress, whether pleasant or unpleasant, mild or severe. Anything placing a demand on the body can cause stress. When stress is pleasant or perceived as a manageable challenge, it can be beneficial. As seen in athletes, business tycoons, entertainers, or great leaders, this type of desirable stress, called eustress, helps arouse and motivate us to persevere and accomplish challenging goals. Consider large life events like graduating from college, securing a highly desirable job, and/or getting married. Each of these occasions involves enormous changes in our lives and inevitable conflicts, frustration and other sources of stress, yet for most of us they are incredibly positive events. Rather than being the source of discomfort and distress, eustress is pleasant and motivating. It encourages us to overcome obstacles and even enjoy the effort and work we expend toward achieving our goals. Physical exercise is an even clearer example of the benefits of eustress. When we're working out at a gym, or even just walking in a park, we're placing some level of stress on our bodies. However, this stress encourages the development and strengthening of all parts of our body, particularly our muscles, heart, lungs, and bones. Exercise also releases endorphins (Chapter 2), which helps lift depression and overall mood.

conflict

Stress can also arise when we experience conflict—that is, when we are forced to make a choice between at least two incompatible alternatives

The questions you just answered in the Psychology and You are based on four factors that research shows are conducive to increased job satisfaction and reduced stress: supportive colleagues, supportive working conditions, mentally challenging work, and equitable rewards (Robbins, 1996). Your total score reveals your overall level of dissatisfaction. A look at specific questions can help identify which of these four factors is most important to your job satisfaction—and most lacking in your current job.

Supportive colleagues (items 1, 2, 3): For most people, work fills important social needs. Therefore, having friendly and supportive colleagues and superiors leads to increased satisfaction. 2. Supportive working conditions (items 4, 5, 6): Not surprisingly, most employees prefer working in safe, clean, and relatively modern facilities. They also prefer jobs close to home. 3. Mentally challenging work (items 7, 8, 9): Jobs with too little challenge create boredom and apathy, whereas too much challenge creates frustration and feelings of failure. 4. Equitable rewards (items 10, 11, 12): Employees want pay and promotions based on job demands, individual skill levels, and community pay standards.

cataclysmic events

Terrorist attacks and natural disasters that cause major damage and loss of life are what stress researchers call cataclysmic events. They occur suddenly and generally affect many people simultaneously. Politicians and the public often imagine that such catastrophes inevitably create huge numbers of seriously depressed and permanently scarred survivors (see photo). Interestingly, relief agencies typically send large numbers of counselors to help with the psychological aftermath. However, researchers have found that because the catastrophe is shared by so many others, there is already a great deal of mutual social support from those with firsthand experience with the same disaster, which may help people cope (Aldrich & Meyer, 2015; Ginzburg & Bateman, 2008). On the other hand, these cataclysmic events are clearly devastating to all parts of the victims' lives (Alvarez, 2011; Gulliver et al., 2014; Joseph et al., 2014). In fact, people who experience extreme stress, such as a natural disaster like the 9.0 magnitude earthquake that hit Japan and caused devastating tsunami waves, show changes in the brain as long as 1 year later (Sekiguchi et al., 2014). Specifically, the hippocampus and orbitofrontal cortex are smaller following stress. Some survivors may even develop a prolonged and severe stress reaction, known as posttraumatic stress disorder (PTSD)

Stress and the Immune System

The discovery of the relationship between stress and our immune system has been very important. When people are under stress, the immune system is less able to regulate the normal inflammation system, which makes us more susceptible to diseases, such as bursitis, colitis, Alzheimer's disease, rheumatoid arthritis, periodontal disease, and even the common cold (Campbell et al., 2015; Cohen et al., 2003, 2012; Sotiropoulos et al., 2015). Prolonged, excessive, and/or chronic stress also contributes to hypertension, depression, posttraumatic stress disorder (PTSD), drug and alcohol abuse, and even low birth weight (Guardino et al., 2016; Kim et al., 2016; Nicolaides et al., 2015). Severe or prolonged stress can even lead to premature aging and even death (Lohr et al., 2015; Prenderville et al., 2015; Simm & Klotz, 2015). How does this happen? Cortisol, a key element of the HPA axis, plays a critical role in the long‐term, negative effects of stress. Although increased cortisol levels initially help us fight stressors, if these levels stay high, which occurs when stress continues over time, the body's disease‐fighting immune system is suppressed. For example, one study found that people who are lonely—which is another type of chronic stressor—have an impaired immune response, leaving their bodies vulnerable to infections, allergies, and many of the other illnesses cited above (Jaremka et al., 2013). What happens during prolonged stress? Long‐term exposure to cortisol can permanently damage cells in the hippocampus, a key part of the brain involved in memory (Chapter 7). Furthermore, once the hippocampus has been damaged, it cannot provide proper feedback to the hypothalamus, so cortisol continues to be secreted, and a vicious cycle can develop (Figure 3.3). Perhaps even more alarming is the finding that long‐term stress in mice not only disturbs their short‐term memory, but also causes changes in the brain, which leads to lasting symptoms of depression and social avoidance

hassles

The minor hassles of daily living also can pile up and become a major source of stress. We all share many hassles, such as time pressures and financial concerns. But our reactions to them vary

Relaxation

There are a variety of relaxation techniques. Biofeedback is often used in the treatment of chronic pain, but it is also useful in teaching people to relax and manage their stress. Progressive relaxation helps reduce or relieve the muscular tension commonly associated with stress

Living in poverty

To make matters worse, living below the poverty line (a chronic type of stressor) can literally make it harder to learn. For example, researchers have found poverty to be associated with particular differences in certain surface areas of the brain essential for academic success (Noble et al., 2015). In addition, MRI brain scans of children who grow up in poverty (see photo), compared to those from middle and higher‐income families, show several important differences in brain structures, including the frontal and temporal lobes, the hippocampus, and overall less gray matter (Hair et al., 2015). These areas of the brain are known to be among the most crucial for academic achievement.

Behavior change

When under stress, do you smoke, drink, overeat, zone out in front of the TV or computer, sleep too much, procrastinate, or take your stress out on others? If so, substitute these activities with healthier choices.

Stressor control

While not all stress can be eliminated, it helps to recognize and avoid unnecessary stress by: analyzing your schedule and removing nonessential tasks, and controlling your environment by avoiding people and topics that stress you. It also helps to find a less stressful job, and to give yourself permission to say "no" to extra tasks and responsibilities.

Intense job stressors reportedly not only increase the risk for potentially lethal physical and psychological problems, but they also leave some workers disoriented and suffering from serious stress even when they're not working (Calderwood & Ackerman, 2016; Tayama et al., 2016; Tetrick & Peiro, 2016). Stress at work can also cause serious stress at home, not only for the worker but for other family members as well. Unfortunately, in our global economy, pressures to reduce costs and to increase productivity will undoubtedly continue, and job stress may prove to be a serious and growing health risk. These risks even apply to our world's top leader

[Q5] Have you ever dragged yourself home from work so tired you feared you couldn't make it to your bed? Do you think your job may be killing you? You may be right! Some research suggests that job stress and overwork (see photo) can greatly increase your risk of dying from heart disease and stroke (Biering et al., 2015; Charles et al., 2014; Huang et al., 2015). In fact, a large, meta‐analysis of the correlation between job strain and coronary heart disease found that people with stressful jobs are 23% more likely to experience a heart attack than those without stressful jobs (Kivimäki et al., 2012). And the Japanese even have a specific word for this type of extreme job stress, "karoshi" [KAH‐roe‐she], which is translated literally as "death from overwork." Can a high pressure job actually take years off your life? To test this question, researchers in one study examined life expectancy on candidates for head of country elections—meaning president or prime minister—in a number of different countries (Olenski et al., 2015). Specifically, the researchers gathered data on the number of years each candidate lived after their final campaign for office. They then compared whether candidates who won the election—and thus served as head of country—had fewer years of life than those who lost the election—and thus didn't serve in this capacity. The researchers gathered data from 17 different countries (including the United States, Australia, the United Kingdom, and Canada) over nearly 300 years (from 1722 to 2015). As they predicted, winning an election was actually bad for your health. Candidates who lost the election lived an average of an additional 17.8 years, whereas those who won lived only an average of an additional 13.4 years. In this case, it actually hurts to win—the winning candidate lost an additional 4.4 years of life! Although this data doesn't explain exactly how winning an election led to a shorter life expectancy, researchers believe that the greater stress experienced by heads of country likely helps explain this difference.

frustration

a negative emotional state resulting from a blocked goal, can cause stress. And the more motivated we are, the more frustrated we become when our goals are blocked. After getting stuck in traffic and being 5 minutes late to an important job interview, we may become very frustrated. However, if the same traffic jam causes us to be 5 minutes late showing up to a casual party, we may experience little or no frustration.

Cancer

among the leading causes of death for adults in the United States. It occurs when a particular type of primitive body cell begins rapidly dividing and then forms a tumor that invades healthy tissue. Unless destroyed or removed, the tumor eventually damages organs and causes death. In a healthy person, whenever cancer cells start to multiply, the immune system checks the uncontrolled growth by attacking the abnormal cells (Figure 3.5). More than 100 types of cancer have been identified. They appear to be caused by an interaction between environmental factors (such as diet, smoking, and pollutants) and inherited predispositions. But this is not to say that developing a positive attitude and reducing our stress levels aren't worthy health goals (Hays, 2014; Quick et al., 2013; Tamagawa et al., 2015). As you read earlier, prolonged stress causes the adrenal glands to release hormones that negatively affect the immune system, and a compromised immune system is less able to resist infection or to fight off cancer cells (Bick et al., 2015; Jung et al., 2015; Kokolus et al., 2014). For example, when researchers disrupted the sleep of 21 healthy people over a period of six weeks, they found increases in blood sugar and decreases in metabolism, which may lead to obesity as well as diabetes

three basic types of conflict

approach‐approach, approach‐avoidance, and avoidance‐avoidance Generally, approach-approach conflicts are the easiest to resolve and produce the least stress. Avoidance-avoidance conflicts, on the other hand, are usually the most difficult and take the longest to resolve because either choice leads to unpleasant results. Furthermore, the longer any conflict exists, or the more important the decision, the more stress a person will experience.

role conflict

being forced to take on separate and incompatible roles

role ambiguity

being uncertain about the expectations and demands of your role (Lu et al., 2016; Memili et al., 2015). Being a mid‐level manager who reports to many supervisors, while also working among the people he or she is expected to supervise, is a prime example of both role conflict and role ambiguity.

general adaptation syndrome (GAS)

then mentally or physically stressed, our bodies undergo several biological changes that can be detrimental to health. In 1936, Canadian physician Hans Selye (SELL‐yay) described a generalized physiological reaction to stress that he called the The GAS occurs in three phases—alarm, resistance, and exhaustion—activated by efforts to adapt to any stressor, whether physical or psychological

Acute stress

generally severe, but short term, with a definite endpoint, such as narrowly avoiding an auto accident or missing an important deadline. In modern times, this type of immediate, short‐term arousal is almost a daily occurrence for most of us. Common symptoms include emotional responses (e.g., anxiety, tension, irritability), as well physical reactions (e.g., transient increases in blood pressure, heart rate, dizziness, chest pains). Thankfully, because acute stress is short term, it generally doesn't lead to the type of extensive damage associated with long‐term stress.

HPA

hypothalamic-pituitary-adrenocortical) axis

emotion‐focused coping

in which we attempt to relieve or regulate our emotional reactions. If you're dealing with the death of a loved one, the pain and stress are out of your control. To cope with your painful emotions, you might try distraction, meditation, journaling, or talking to a friend and/or therapist, which are all healthy forms of emotion‐focused coping.

Health psychology

is the branch of psychology that studies how biological, psychological, and social factors influence health, illness, and health‐related behaviors. It emphasizes wellness and the prevention of illness, as well as the interplay between our physical health and our psychological well‐being. As mentioned earlier in this chapter, ulcers, cancer, cardiovascular disorders, and PTSD significantly affect our physical well‐being, as well as our cognitive, emotional, and behavioral responses. In this final section, we'll discuss the work of health psychologists, followed by an exploration of stress in the workplace.

Gastric Ulcers

lesions in the lining of the stomach (and duodenum—the upper section of the small intestine) that can be quite painful. In extreme cases, they may even be life‐threatening. Beginning in the 1950s, psychologists reported strong evidence that stress can lead to ulcers. Studies found that people who live in stressful situations have a higher incidence of ulcers than people who don't. And numerous experiments with laboratory animals have shown that stressors, such as shock, water‐immersion, or confinement to a very small space, can produce ulcers in a few hours in some laboratory animals 75% of normal, healthy people's stomachs also have the bacterium. This suggests that the bacterium may cause the ulcer, but only in people who are compromised by stress. Furthermore, behavior modification and other psychological treatments, used alongside antibiotics, can help ease ulcers. In other words, although stress by itself does not cause ulcers, it is a contributing factor, along with biological factors

optimism

positive affect is also closely associated with optimism, the expectation that good things will happen in the future and bad things will not. If you agree with statements such as, "I tend to expect the best of others," or "I generally think of several ways to get out of a difficult situation," you're probably an optimist. The opposite is true if you tend to be a pessimist. As you might expect, optimists are generally much better at stress management. Rather than seeing bad times as a constant threat and assuming personal responsibility for them, they generally assume that bad times are temporary and external to themselves. Optimists also tend to have better overall physical and psychological health, and typically have longer and overall happier lives To test this question, researchers in one study tracked 135 older adults (aged 60+) over six years (Jobin et al., 2014). Participants were asked about the level of stress they perceived in their day‐to‐day lives, and whether they would rate themselves as optimists or pessimists. Saliva samples were then collected from each individual to measure his or her current level of cortisol. Interestingly, the results revealed that compared to self‐described optimists, people who described themselves as pessimists had higher cortisol levels, a higher baseline level of stress, and more difficulty coping with it. Can you see why optimists tend to experience better overall health? Their lower cortisol levels and better coping strategies reduce the "wear‐and‐tear" of the biological effects of stress on their bodies. The good news is that according to Martin Seligman, a leader in the field of positive psychology, optimism can be learned (Seligman, 2012). In short, he believes optimism requires careful monitoring and challenging of our thoughts, feelings, and self‐talk. For example, if you don't get a promotion at work or you receive a low grade on an exam, don't focus on all the negative possible outcomes and unreasonably blame yourself. Instead, force yourself to think of alternate ways to meet your goals and develop specific plans to improve your performance. Chapter 13 offers additional help and details for overcoming faulty thought processes.

Problem‐focused coping

strategies work to deal directly with a stressor in order to eventually decrease or eliminate it (Delahaij & van Dam, 2016; Dixon et al., 2016; Mayordomo‐Rodriquez et al., 2015). We tend to choose this approach, and find it most effective, when we have some control over a stressful situation. Although you may feel like you have little or no control over exams and other common academic stressors, our students have found that by using the various study tools provided throughout this text and on our text's website, they increased their personal control and success, while also decreasing their stress levels. Do you see how this approach of studying and adopting new study skills would be a good example of problem‐focused coping?

Stress and task complexity

stress can benefit performance. However, the level of stress should match the complexity of the task. Note how a higher level of stress helps keep us focused during well‐learned, very easy tasks, but we may need to intentionally raise our stress levels to better focus our attention when the easy task demands it (A). During moderate tasks (B), we need a medium level of stress for maximum performance. In contrast, during complex, demanding tasks (C), we need to lower our stress level. For example, during difficult exams your performance will benefit from deep breathing and other methods of relaxation. Before going on, it's important to note that even highly stressful events can, in some cases, be surprisingly beneficial. Researchers compared data for psychological adjustment, including anxiety and depression, in female students before the 2007 shooting at Virginia Tech (as part of an already on‐going study), and then again after the event (Mancini et al., 2016). They found that some students suffered continued distress after the shooting, while others showed relatively long‐lasting psychological improvement and resilience. On the face of it, this sounds absurd. However, numerous studies have shown that the outpouring of social support after mass traumas can promote greater cooperation, sharing, solidarity, and bonding among the survivors. One researcher described it as "a paradise built in hell"

See page 69

the SAM System and HPA Axis—Two Co‐Actors in Our Stress Response Faced with stress, our sympathetic nervous system prepares us for immediate action—fight‐flight‐freeze. Our slower‐acting HPA axis maintains our arousal. Here's how it happens:

stress

the process by which we perceive and respond to certain events, called stressors, that we appraise as threatening or challenging

stressors

we generally know what a person means when he or she speaks of being "stressed." But scientists typically define stress as the interpretation of specific events, called stressors, as threatening or challenging