Chapter 10 - Stress and Coping

Stimulus-Oriented Viewpoint

Explanations of stress that are focused on the stressors themselves, the stimuli or life events, that trigger the stress reactions. The viewpoint of Holmes and Rahe's theory of life-change events.

Alcohol, Drugs and Stress

Is a coping mechanism people use but not an effective one. Substance abuse at all levels is related to stress levels. The relationship differs by gender and race. A study at a university looked at general college life stress (problems with professors, grades, relationships) and found an association with increased alcohol in all groups except black males. Traumatic stress (victimization and violence) was related to alcohol problems for white students only and with binge drinking in white female students. Not a representative sample.

Primary Cognitive Appraisal

Is the event: -Irrelevant -Benign -Positive Then no stress, but... Does event imply: -Harm/loss -Threat -Challenge Then stress and go to Secondary appraisal Event: You have to ask yourself a question, whether its relevant (does it affect you), benign (potentially related or doesn't affect you), or positive (no stress or eventual) such as being of singled out for your good grades. Imply: Harm or loss can be physical or psychological, a threat, or a challenge such as you have the skills but at that moment in time you can't. Which causes stress and secondary appraisal.

How does social support affect the elderly?

It reduces the negative impact of stressful experiences. A study of those over 65 found that those who had experienced a major negative life event, those who showed the most resilience (low depressive symptoms, high life satisfaction) were those who had larger social networks and happier marriages. It can help people define the course of stress, plan solutions, find a sense of meaning in life, or assist with the buildup of chronic stress. It is an asset to have a good friend or relative who helps the older person come to terms with distressing circumstances.

Emotion-Focused Coping

Stress reducing technique that directly addresses the emotions causing stress. Ways that people try to ameliorate the negative emotions associated with the stressful situation. Positive would be going for a run to clear you head. Negative would be using drugs or alcohol to escape. Distancing oneself from the problem can be helpful but also maladaptive.

Chronic Stress Symptoms

Experienced by 10-30% of people exposed to trauma and are severe reactions immediately after the traumatic event and remain severe for 2 years afterward.

Response-Oriented Viewpoint

Explanations of stress that focus on the physiological reactions within the individual. The type of viewpoint of Seyle's GAD theory. A focus on the psychological reactions within the individual that resulted from exposure to stressors.

General Adaptation Syndrome

In Seyle's theory, three stages of symptoms that occur in response to stress: alarm reaction, resistance and exhaustion. Alarm Reaction: in which the body quickly responds to a stressor by becoming alert and energized, preparing for fight or flight. If the stressor continues for a long time, the body goes into its second stage. Resistance: When a stressor continues for a longer time, the body attempts to regain its normal state. In this stage a notable physical change is the thymus gland which is involved in immune responses, and decreases in size and function. In this phase a person is able to control the initial alarm reaction to the stressor but does so at the expense of the immune function. Exhaustion: If the stressor continues long enough (like many chronic stressors), the second phase can't be sustained and they enter this stage when some of the alarm-stage responses reappear. If the stressor is severe enough, exhaustion is accompanied by physical illness or death. Return to rest after a stressor has stopped and the GAS is terminated is never complete. One can only get near their original state, not fully, which suggests that the process of aging may thus be the accumulation of the effects of years of stress.

What are the questions that were raised about the stimulus-oriented viewpoint and life-event scales as a definition and a method of stress measurement?

Its not so obvious that life changes all produce stress in the same way. Are positive life changes and negative changes really equally stressful? There may be life changes that can be classified as negative or positive but the question is whether or not their subvarieties are more stressful or more likely to lead to illness. Positive events in one situation like getting pregnant can be stressful to another person say if the person is a teenager, etc.

Cognitive Reappraisal

Monitor the effectiveness of implemented strategy -Is it working? If so, exit stress system -If not, implement plan "B" from secondary appraisal. -Continue until strategy works. It is meant to monitor effectiveness. If working, then you exit, if not then plan B which is similar to a new plan/appraisal which means you start over with irrelevant, benign, etc (Primary Appraisal). How we interpret an event can blow things out of proportion - but social support, coping, etc help

Daily Stressors

Routine challenges of day to day living such as world deadlines, malfunctioning computers and arguments with family. They also include more chronic challenges such as caring for a sick spouse, balancing being a single parent, working parent. Occur more frequently, have serious effects on well-being. They not only have direct and immediate effects on emotional and physical functioning, but accumulate over time to create persistent problems that may result in more serious stress reactions. Are difficult to measure because they are small issues that are not easily recalled over time. A study by Almeida found that Americans typically experience at least 1 stressor on 40% of the days studied and more than 1 on 10% of the days. The most common stressor was interpersonal arguments and tensions, accounting for 1/2 of reported stressful events. The subjective appraisal of the severity of stressful events was average overall, whereas the objective appraisals were low. Which means that we tend to perceive our own stressful events as more severe when they are perceived by a noninvolved rater.

What is Taylor's theory of stress reactions between men and women?

She says that men and women have evolved different survival and reproductive behaviours, and that females may have developed a different stress response. With a genetic predisposition to "tend and befriend", instead of fight or flight, a women's response is aimed at tending one's immature offspring and seeking support from others, especially other females. Females respond by nurturing and protecting offspring, and reduce neuroendocrine responses that may compromise offspring health (tending) and by befriending - affiliation with social groups to reduce risk. The response to stress may be based on attachment caregiving process and maybe regulated by hormones. It correlates with the fact that women have larger social networks and deeper emotional friendship. Are more apt to respond to emotional events by seeking friends and talking. They are the caregivers and kinkeepers.

Self-Identity

These people with a strong sense of self appear to experience less stress at stressful times than those who do not. They feel a continuity of the self and are better able to cope with changes around them.

What do evolutionary psychologists suggest the reaction to acute stress is?

They suggest that the acute stress reaction, fight or flight, is an adaptive mechanism that enabled our primitive ancestors to summon optimal levels of energy (increased adrenaline and blood supply) while at the same time preparing the body for accelerated healing of wounds and infection prevention (natural immunity). Even though modern humans seldom need this set of responses because we encounter different stressors now, but as with other evoked mechanisms, the stress response reflects the demands of more promoted environments which results in a mismatch of physical responses to psychological events.

Coping Behaviors

Thoughts, feelings and actions that serve to reduce the effects of stressful events. An all purpose term the prefers to anything you think, feel and do to reduce the effects of stressful events. -Self-distraction: Looking at other activities to take their mind off things. -Active coping: Doing something about the situation you're in. -Denial: Thinking its not real. -Substance Use: Drugs and alcohol. -Use of Emotional Support: Getting comfort from someone. -Use of Instrumental Support: Getting help and advice. -Behavioral Disengagement: Giving up. -Venting: Saying unpleasant feelings. -Positive Reframing: Looking for something good within the problem. -Planning: Come up with a strategy. -Humour: Making light/jokes of it. -Acceptance: Learning to live with it.

Social Readjustment Rating Scale

-Events experienced by most people and assigned a rating. -Some events need more or less readjustment. -Comparing illness to readjustment. Correlations between .25 and .40.

Subcategories Of Stressors/Life Change Events

-Short Term Life Events -Chronic Life Strains -Work Stress -Work Strain -Major Life Events -Daily Stressors

Chronic Life Strains

Continuous and ongoing. They type of stressors that cause the most health problems and eroded social relationships - which is ironic because social relationships alleviate stress.

Major Life Event

Divorce or death of a loved one. May be associated with prolonged psychological reactions.

Stressors

Environmental demands that lead to stress reactions.

Hans Seyle

Gave the best known explanation of the stress response and first coined the term "stress" and then developed the concept of General Adaptation Syndrome - three stages of symptoms that occur in response to stress: alarm reaction, resistance and exhaustion. This theory was one of the earliest demonstrations of the link between psychological reactions and physical illness. The stress itself does not cause physical changes, but the reaction to stress (distress) is the culprit. Which opens the door to preventative measures like coping mechanisms and social support. He was looking for a new hormone and was injecting rats with ovarian extract as a standard method. He found that other extracts like spleen liver produced the same result. He determined that "noxious agents" produced a common set of consequences. AKA: GAS.

Work Stress

High demands on the job but a good amount of control and sense of personal accomplishment.

Stress & Cognitive Appraisal

Lazarus & Folkman define stress in dynamic and interpretive terms as: "...a particular relationship between the person and the environment that is appraised by the individual as taxing or exceeding his or her resources and endangering his or her well-being". Three types of cognitive appraisal: -Primary -Secondary -Reappraisal Its dynamic and interpretive - like a dance. What's going on and how it changes.

Resistance Resources

Personal and social resources that may buffer the person from the impact of stress. Central among these are individual coping responses, sense of personal control and the availability of social support.

Social Coping

Stress reducing technique that involves seeking both instrumental and emotional support from others. Ex: calling a friend to share bad news and they offer kind words of support. Women report using this form of coping over men.

Post Traumatic Stress Symptoms

Term used to describe reactions to trauma that are severe, but do not fit the full diagnosis criteria of PTSD.

Coping

Ways to reduce the effects of stress reactions. An antidote to stress.

Do men and women report different levels of stress?

When it comes to daily stressors, women report more days with at least one stressor than men do. They also report different levels of stress. Men are more apt than women to report daily stress related to work or school and women speak of events happing to people in their social or family networks. Men mention stress that threatens then financial and women say what threatens the way others feel about them.

Who suffers greater effects of stress when they don't have adequate social support in their lives?

Women who fill multiple roles of parent, wife, worker and caregiver.

Are there gender differences in the response to PTSD?

Yes. Men are more exposed to trauma then women during their lifetimes, but women are more likely to experience PTSD as a result of a trauma. The types of experiences differ by gender and some events are more likely to contribute to PTSD such as women are more likely to experience rape but men suffer with PTSD more often from rape. Men have a higher rate of experiencing physical assault than women, but women develop PTSD more often from assault. The likelihood of developing PTSD as the result of a traumatic experience depends on more factors than just the objective severity of the event.

What two abilities are important in dealing with the stressors in life?

1) The ability to use a variety of coping skills, which depending on the situation is called coping flexibility. 2) The ability to match the appropriate coping skill with the situation called goodness of fit.

Recovery

15-35% of reported people and begins with moderate to severe reactions but becomes mild 2 years after the trauma.

Personality Traits and Coping

A sense of optimism is a major buffer against the impact of stress. Whether one has an internal vs. external locus of control, optimism vs. pessimism/helplessness, makes a big difference. If a person is optimistic they are less likely to become physically ill or depressed. A sense of control serves as a buffer against stress, similar to how social support works as a buffer. Among people who face some major life change or chronic stressor, those who approach it with a strong senes of self-efficacy or optimism are less likely to develop physical emotions or emotional problems and more likely to recover quickly from physical problems.

Stress

A set of physical, cognitive and emotional responses that humans and other organism display in reaction to stressors, or demands from the environment. Environmental demands are known as "stressors".

Resilience

Ability to maintain healthy functioning following exposure to potential trauma. It is not the same as recovery and different from chronic or delayed post traumatic stress reactions and recovery. It is a reaction that may involve slightly increased disruption at the time of the trauma, but never leaves the mild range. It is the most common response to traumatic stress and is found in 35-55% of people who are exposed to a traumatic event.

Delayed-Stress Reactions

Account for 5-10% of reactions and begin moderate but increase to severe 2 years after the trauma.

Meaning-Focused Coping

Stress reducing technique that refers to anything you might think, feel, and do to give a positive meaning to a stressful situation. The ways that people find to manage the meaning of a stressful situation. Especially useful in chronic stress situations like caregiving. Ex: After a fire, telling oneself that the loss was only material and at least your pet and family are okay. Things happening for a reason.

Proactive Coping

Stress reducing techniques done in advance of a potentially stressful event. The ways people cope in advance to prevent or mute the impact of a stressful event in the future such as a scheduled medical procedure or impending work layoff. There are 5 interrelated components of proactive coping: -Building a reserve of resources. -Recognizing potential stressors. -Initial appraisal of stressors. -Preliminary coping efforts. -Seeking feedback about one's success and acting on it. Ex: pending hurricane; people board up house, get food, get gas, cash, check generators, get candles and flashlights, water, etc. People build a reserve of resources and recognize potential stressors such as property damage, the weather, losing electricity and water supply, danger and injury, no cell phones or internet, etc.

Resilience, Post Traumatic Growth & Wisdom

THESIS (pre-trauma) - ANTITHESIS (trauma) - SYNTHESIS (wisdom) A stressor changes a person's world and then that predicted post-traumatic growth, which then predicted wisdom. Posttraumatic growth can be connected to significant development of wisdom and of the individual's life narrative. The assumption is that as individuals experience posttraumatic growth, these changes have an ongoing, mutual influence with the development of general wisdom about life and further development of the general framework, the narrative, people have for thinking about their lives.

Positive Emotion & Laughter

Evidence shows that people who respond to aversive events with positive emotion (gratitude, concern for others, love, laugher) have better adjustments than those who are negative. This behaviour brings out more positive responses from family and friends in their support network. Ex: bereaved spouses who spoke about their loss with loving stories and laughter showed better adjustment over years following the loss.

Stress-Related Growth

Positive changes that follow the experience of stressful life events. Crisis or stress can make useful changes in the individual and that personal growth may result from facing difficult life events.

General Adaptation Syndrom - Class Slides

Specific stressors cause specific responses. Ex: Heat causing vasodilation. Any stressor causes a collection of non-specific, or general responses. Ex: Swelling of adrenals, shrinkage of thymus. The GAS has 3 phases: Alarm: The bodies immediate response to a stressor - fight or flight; release of adrenaline. Ex: a startle response, its automatic, like a jump to a loud noise. Resistance: Ongoing physiological efforts to combat stressor - release of cortisol. We are unaware, its chronic/ongoing. Examples are people getting sick near exams because of the undue stress they put on their bodies. They are working hard to function. -Thymus gland = immune system. More or less T-Cells. Exhaustion: Depletion of bodies physical resources which may contribute to illness if prolonged or death. We try to make adjustments. There is a connection between disease and stress. Typical responses from animals are called "general responses".

Are life stressors and physical illness related?

Yes. Studies have found linear relationships between the accumulation of stressful life events such as divorce or death, job loss, etc is associated with an increased risk of breast cancer. The greater number of stressful events women reported in a study the greater the chance of breast cancer. There is a link between stress and heart disease. Work related stress such as being laid off or failure of a business was related to increased risk of death from heart disease. The number of stressful events the higher the risk. There is a link between stressful events and risk for heart disease and diabetes. Testing for cardiovascular disease and diabetes, men who were at the highest risk for both had higher scores on their life-change questionnaires.

Work Strain

Results from situations in which a worker is faced with high demands but low control, no sense of personal accomplishment and low reward.

General Assessment Tool (GAT)

A tool to identify individual soldiers who are susceptible to PTSD and provide special interventions as part of their training procedure. Compares soldiers with the Army norms for emotional, social, family and spiritual fitness. Looks at their personality and whether they apply external or internal locus of control, looks at their sense of meaning and purpose, their active methods of coping, how they think and if they're flexible. Measures how well they can handle adversity. Recommends training and skills and active problem solving. Focuses on evaluating soldiers on attributes that affect coping and resilience, and then provides training in low-scoring areas, and is a different approach than waiting until symptoms of PTSD are diagnosed after exposure to a trauma and then trying to remedy that. An application of positive psychology.

Life Change Events

In Holmes and Rahe's theory, events that after the status quo of an individual's life; when accumulated can lead to stress reactions. Developed a rating scale that consists of 43 events with points assigned to each event depending on how much stress it causes. Ex: death of a spouse = 100 points, being fired = 47 points. They focused on life changes, not negative events, and included some positive events like pregnancy, achievement, vacations. They hypothesized that the more points a person had accumulated in the past year, the higher the stress level and the greater the chances of illness in the near future. They approached the topic of stress from a stimulus-oriented viewpoint. Their rating scale proved to be fairly accurate predictor of illness and psychological symptoms.

Do men and women differ in their social support needs?

In a study of intimate reciprocity; social support given and received between close people, found that men benefit the most from receiving social support and women benefit from giving it.

Of the four outcomes people can have after exposure to a trauma, what is the most prevalent?

Resilience. The others like chronic stress, delayed stress and recovery are not as typical. It is the most common outcome. NOT recovery or PTSD.

Simplistic Model of Stress

Stressor = Stress Response An external event causes different outcomes/responses based on how each person interprets the event.

Short Term Life Events

Stressors that may cause immediate problems but have a definite beginning and end.

Perceived Social Support

Three Types: -Emotional E.g., empathy, validation, affection, humour. -Tangible E.g., physical chores, financial assistance, errands. -Informational E.g., advice, guidance, tips. When you really need one type of support but you get another, such as needing emotional but getting informational = it adds to more stress.

Can negative effects of stress have positive effects?

Yes. One study of middle aged adults whose parents recently died shows that although they reported typical symptoms of emotional distress, many also reported they experienced personal growth as a result, and they felt they were complete adults with increased self-confidence and a sense of maturity. They learned to value personal relationships. Other events such as terrorist attacks or divorce; studies have found that positive and prosocial reactions have come from the tragedy including interpersonal closeness, increase in donations, charitable giving and volunteering. A study of veterans found that those exposed to moderate levels of stress in combat and who believed there were benefits to serving in the military showed higher levels of wisdom. Its how one appraises and copes with problems may be the key to deriving benefits from stressful experiences. Depending on the stressful event, the personal beliefs of the individual, and support available, people in most dire circumstances are able to report personal growth, increased wisdom, relationship growth, application for life, sense of maturity, stronger religious beliefs and greater self-efficacy and self-confidence.

Who experiences the highest amount of stress?

Young adults experience more, but in general stress decreases with age. A study found that the majority/proporation of days people experienced stress declined after middle adulthood and women reporting more days with stress than men at all ages. The reason is that young people have more complex lives and thus more avenues for stress. Older people have more experience with stressful events and likely have developed coping strategies for situations that may become stressors. While older people have more health problems and experience more loss, they often compare their own situations with others their age and consider themselves doing well.

What are the limitations of checklist methods of stress?

-Cause-effect is equivocal: Ex: sexual difficulties - consequence or cause of stress? Eating patterns, etc. Is it the event or the illness? -Ignores timing issues: 1) The density or clustering of events. 3 events a day versus 3 events a month - the 3 a day are more noxious/difficult. Density and timing. Ex: getting into a fight with one's spouse and then having a huge car accident is going to be more stressful if on the same day than if say a few days or weeks apart. The straw that broke the camels back. 2) Ontogenetic schedule Ex: When an event occurs developmentally such as getting pregnant at 14 versus 28. Life events are interpreted differently in terms of stress levels. -Ignores cognitive evaluations. Ex: How we interpret events modifies our stress response(s). How we think about events plays a strong role. It all depends on the situation, and the person's place in time. -Ignores "daily hassles" (Almeida: primarily interpersonal tensions) Ex: driving a long commute every day versus a quick walk to work. Stronger predictors of illness because these are ongoing stressors.

What are the two separate types of immune responses postulated by Selye's idea of stress leading to a general suppression of the immune system?

1) Natural Immunity: a quick defence against pathogens in general. 2) Specific Immunity: a slower and requiring more energy response because the body needs to identify specific pathogens and form matching lymphocytes to combat them. Ordinarily the two systems work in balance, but a stress reaction results in the natural immune system going quickly into overdrive and the specific immune system being suppressed to conserve energy. Stressful events of longer duration, like mourning, lead to a decline in the natural immune system over time and an increase in the specific immune system. When stress is chronic, like caregiving, both immune systems eventually decline in function.

Coping - Lecture Slide

1) Problem-focused - attempts to eliminate or attenuate the source of the problem -Use respite care; replace mouldy drywall; get English tutor; fire abusive employee. -Concrete solutions, its direct, and more common in younger adults. 2) Emotion-focused - attempts to modify our emotional reactions to the problem. -Use humour; cultivate a philosophical outlook; distancing; garner emotional support; look on the bright side; escape-avoidance (generally less adaptive or healthy style). -Older adults. 3) Meaning focused - develop religious or spiritual strength (God is testing me); reconceptualize event as providing direction or purpose; see stressor as means to exercise values (e.g., fidelity, perseverance, strength, etc). -Ex: before this happened I never knew I had the strength to take this on, etc. -The event or problem changes one's outlook. *You can't actually change the stressor, such as a spouse dying, so you need to adjust your style. -As we age we lose or change roles, so adults are likely to be emotionally focused. Younger people will take direct approaches like getting tutors or help whereas older people will think about life experience within the issues.

What are the factors involved in the buildup of daily stressors?

According to Almedia's model, the factors that can affect the stress/wellbeing connection are SES, Psychosocial and Health. SES: -Age, gender, education, income, marital status and parental status. Psychosocial: -Personality traits, mastery, chronic stress, life goals. Health: -Chronic health problems, acute disease, mental health. Characteristics of the stressor are frequency, content, focus of involvement and objective severity. Ex: A young women in good health, living at home and in school who is faced with transportation issues regularly due to undependable car, so its a daily hassle to ask friends or family. If it continues the whole semester the chances are it won't have a negative effect on well being. Its just inconvenient hassle. But a middle aged man on disability, poor health who needs to see doctor weekly may see the same transportation problems as more severe. Becomes a drain on well being and then feeds back into individual factors causing them to decline more. The young girl on the other hand has more social supports.

Hardiness

According to S. Kobasa, "hardiness" consists of a combination of: -Commitment: "tendency to involve oneself in (rather than experience alienation from) whatever one is doing or encounters." You jump into the task and don't give up. -Challenge: "the belief that change rather than stability is normal in life and that the anticipation of changes are interesting incentives to growth rather than threats to security." Change is normal, there is incentive to grow, you learn and adapt, can see it as interesting and not threatening. -Control: "tendency to feel and act as if one is influential (rather than helpless) in the face of the varied contingencies of life." You feel and act as if you have the power or influence when shit hits the fan. Hardiness is the resources to deal with the 3 Cs. Each dimension is considered to be normally distributed. "Hardy" individuals are those who score high on all three dimensions. Found that hardy business executives suffered less stress-related illnesses at the end of a two year period. Hamama-Raz & Solomon (2006) investigated well-being and distress levels in melanoma survivors. Hardiness correlated +.37 with well-being; -.42 with distress. A personality construct which describes people who are committed to finding meaning in life, believe that they control their surroundings and the outcome of events. They believe that all life experiences are periods of growth and knowledge. They approach difficult situations with less fear and with confidence that they'll cope and maybe even benefit from the experience. They use more coping skills and have more social support than others who don't fit this type.

Secondary Cognitive Appraisal

Creation of a mental inventory of possible coping strategies. Example: -"What can I do about that allegation?" Admit it, Sic my lawyers on her, Call it fake news, Fire them. You prioritize above options and implement choice. Its a method of creating a mental inventory of coping strategies. Prioritize and implement choice, and if the choice A works, you have lower stress. But if it doesn't work, you go back to your inventory and try plan B.

What do studies show about the effect of social environment on gene expression?

One study conducted by Cole took a group of socially isolated individuals and a control group who were more socially integrated. Earlier research showed that those who are socially isolated have more incidences of illness and die at earlier ages than those who are more socially integrated in their communities. They discovered two types of immune response genes that differentiated the groups - one that responded to bacteria and one that responded to viruses. When the genomes of the participants were examined, they found that the altered genes were those involved in regulating information; a key symptom of many of the diseases that socially isolated individuals developed. Similar genetic changes have been experiencing other types of stress, such as ongoing interpersonal difficulties, low socioeconomic status, and ptsd. Individual differences in adulthood have been shaped by our perceptions of the social environment, and those differences have altered the way our genes express on an individual basis.

Self-Complexity

P. Linville argues that our self-defining roles, values, and actions collectively constitute important aspects of our self. Self-complexity has two elements: -Quantitative: The number of fundamental roles to which we ascribe. -Qualitative The distinctiveness among these roles. To diversify one's resources. It is relative to one's identity. You don't count on just one thing or see yourself in just one way. For if you do, it can lead to disappointment. One should be complex and see themselves in multiple ways with multiple selves. In a study they gave people an engineering test. Some got a false negative/bad news and some got a false positive/good news. They then rated moods and emotion. High self confidence with a false negative equate to these people not having a large mood change/didn't affect their life significantly. Those with high self confidence and a false positive only confirmed their status/beliefs. Those with low self confidence and a false negative had a massive shift in emotion. Their esteem sank. Self complexity is like a buffer.

Buffering Effect

Pattern of results that cushion the outcomes of a distressing situation. The benefit of social support is even stronger when a person is under high stress - the negative effect of stress on health and happiness is smaller for those who have adequate social support than for those whose social support is weak. The buffering effect of social support won't keep stressors from entering one's life, but it will provide some protection against the harm stressors do. Support in a high stress situation may serve as a buffer against later stress reactions such as depression and that social support is an important buffer against negative mental health consequences of stress and trauma.

Social Support

Positive affect, affirmation, and aid received from others at stressful times. -Quantitative versus qualitative. Some support networks are reciprocal, some aren't. -More is not necessarily better. -Not everyone in your social network is supportive. Its the perception of what we get out of the relationships. Ex: "Hi, its Jim. Can I borrow your notes? Your car? Your money?" -Our perceptions of what we get out of relationships is more predictive of effective coping -Perceived social support - three types. A person's perception of the quality of their social contacts and emotional support is more strongly related to physical and emotional health than are most objective measures, just as subjective measures of stress have turned out to be more accurate predictors of stress responses than just listings of life-change events. Its not the actual amount of contact that's important but how that contact is interpreted. Adults who have adequate social support have lower risk of disease, death and depression that adults with weaker social networks or less supportive relationships.

Post Traumatic Stress Disorder

Psychological response to a traumatic experience. Symptoms include re experiencing the event in intrusive thoughts or dreams, numbing of general responses, avoiding stimuli associated with the event, and increased arousal of the physiological stress mechanisms. It does not decline over time and not alleviated by social support. Treatment includes counselling, problem-focused cognitive behaviour therapy, and medication. With therapy, one should address feelings of vulnerability and powerlessness. Examine source of fear and correct exaggerated beliefs which is difficult since avoidance of thoughts of the trauma make this not possible. 1/3 of people will show symptoms immediately while 10% continue showing symptoms as year later. The biological effects involve more than just extreme general anxiety reactions. The responses are different in these patients and so are hormone levels. There are different areas of the brain involved in the responses and people with PTSD often have structural alterations in the hippocampus and amygdala. Long lasting alterations in the brain and nervous system leading to changes in the stress reaction mechanism which causes intrusive throughs, numbing and increased reactivity of stress response mechanisms.

Religious Coping

Stress reducing techniques that involve relying on religious or spiritual beliefs. Ranges from finding meaning in suffering, achieving a sense of control by trusting in the divine, gaining social solidarity with others who have similar beliefs. You can categorize it positive or negative. Positive is trusting that God will take care of your problems and believing in a higher power with a reason for everything. Negative is when people wonder if God has abandoned them or questioning whether he really loves them. Positive coping leads to positive adjustment to stress, but negative is related to negative adjustment. A study found that negative religious thoughts was related to increased risk of death in hospitalized adults.

Problem Focused Coping

Stress-Reducing techniques that directly address the problem causing stress. Taking direct action such as making calls, taking an inventory, finding out information, asking for assistance.

Complex Model of Stress

Stressor + Mediators = Response Mediators are control, predictability, appraisal, personality, social supports and coping. Response can be either adaptive or maladaptive. Ex: if someone drinks when stressed or they listen to music and sleep. Control is an important element to how stressful an event is. Lacking in control the event is more stressful. Predictability can affect response. If you know an event is going to happen, you are less noxious, but if you don't know and its random then there is more stress.

Human Social Genomics

Study of the changes in gene expression that result from subjective perceptions of the environment. The expression of our genes can be influenced by the internal social conditions we experience, and how we subjective perceive those conditions.

What have studies of widows and widowers found about resilience?

That their reactions are near 50%. They did not suffer from delayed grief, and they were not superficially attached to their spouses. They found that after the death, almost 1/2 showed low levels of depression and had relatively few symptoms of grief. They scored high on death acceptance, belief in a just world, and had a strong support network. Their grief symptoms did not interfere with their ability to continue their lives nor their ability to feel positive emotions.

Grief Work

The Freudian based idea that everyone experiencing a traumatic loss must work through the negative feelings and let it all out. The concept labels resilient people as pathological, ether in denial or showing abnormal detachment. Grief work may be unnecessary and even harmful. A study found that 38% people involved in grief work therapy got worse when compared to a control group with no treatment. This type of therapy expects people to express emotions they may not feel, and then questions your mental health or your attachment to the deceased loved one. It could result in secondary trauma.

Is there a link between stress and discrimination?

Yes. Black adults in the USA have greater incidence of high blood pressure and stroke than other racial/ethnic groups. Racial discrimination is seen as a chronic stressor that can elevate blood pressure and increase risk of stroke. A study found a relationship between perceived racism and changes in blood pressure following a public speaking task. The higher the reports of perceived racism, the more systolic blood pressure was elevated as a result of giving a short talk before an audience. Other studies have shown that hypertension is higher for Hispanic black people than hispanic whites, suggesting that health disparities are more driven by race than immigration experience or language group. Those who perceive chronic discrimination against their groups were 2 to 6 times more likely to show high-risk markers for cardiovascular disease than those in the same group with no perceived discrimination. Moreover, people in minority groups react differently to stressors than those in majority groups. Being in a minor brings slower level of coping resources. Discrimination is the opposite of social support during stress. Discrimination combined with lower SES factors and opportunities may explain the amount of stress-related health problems in minority groups.