Unit 11

The field of health psychology integrates research on health and psychology to promote
wellbeing. Well-being is defined as a positive state that includes striving for optimal health and
life satisfaction. Our behaviors and attitudes are important for keeping us healthy and well. These
are known as health behaviors, including things like exercise, eating habits, smoking and
alcohol use.

The field of health psychology follows a biopsychosocial model of health and illness. Each
component of the model is an important contributor to our health and well-being.

• The biological characteristics that contribute to health and well-being include our genetic
predispositions and nervous system development.
• The psychological factors that contribute to health and well-being include our thoughts
and actions and how we experience stress.
• The social conditions that contribute to health and well-being include our neighbourhoods
and relationships.

Health psychologists are interested in health behaviors because they have a direct impact on
mortality. Here we see that our health behaviors contribute to all of the 10 leading causes of
death in Canada.

Health Behaviors: Daily habits such as poor nutrition, overeating, smoking, alcohol use, sleep,
and lack of exercise, contribute to nearly every major cause of death in developed nations.

This figure shows strong negative correlations between three particular health behaviors and life
expectancy rates in Canada. The pattern is the same for each behavior. People who smoke more,
people who are obese, and people who drink heavily have shorter life expectancies.
Life expectancy also varies as a function of geography. Here we see that people living in urban
centers, like Montreal, have higher life expectancies, compared to the national average. You can
see other urban areas in Canada are predominately green in colour as well. Areas that are shaded
orange are areas where life expectancy is lower than the national average. You can see that these
areas tend to be rural areas that fall outside Canada’s large urban centers.

One of the factors that accounts for differences in life expectancy between urban and rural parts
of Canada is income level. Here we see that for both males and females, those who live in higher
income neighbourhoods have greater life expectancy. Those in the highest income
neighbourhoods can expect to live 5 years longer than those in the poorest neighbourhoods
This figure from the textbook shows how neighbourhood differences in income contribute to life
expectancy discrepancies by racial group in the United States. Although life expectancy has
increased in the United States since 1970, African Americans continue to lag behind white
Americans, in life expectancy. This discrepancy is referred to as a health disparity.

In Canada, the greatest health disparities exist for indigenous peoples.

We can use the biopsychosocial model to understand health disparities. Although some of the
discrepancy may be accounted for biological factors, like susceptibility to particular diseases,
most of the disparities are accounted for by social conditions and psychological factors that arise
from those social conditions, like experiences of stress.

Stressors and stress

An important distinction psychologists make when studying stress is the distinction between a
stressor and stress. A stressor is the stimulus or event in the environment that places some sort
of demand on the organism. The demand requires some sort of adaptive response, depending on
howit is perceived, possibly as threatening, demanding or challenging.

There are two major categories of stressors.

• First are life events that involve major life changes. These are not necessarily negative
events, but events that pose challenges nonetheless. Take for example a wedding: although
the wedding itself is a joyous event, the planning of a wedding can be quite stressful.
o Stress derived from positive events is called “eustress”.
o Stress derived from negative events, like a car accident, is called “distress” or
“duress”.
• The second major category of stressors consists of daily hassles. These are the day-today
irritations and annoyances we face: traffic, difficult people at work, long line ups, and
even parenting qualify as daily hassles.

When we experience a life event or daily hassle, we may experience stress in response to those
events. Stress is defined as the pattern of responses to a stressor that disturb our equilibrium and
tax or exceed our ability to cope. As a result, we may experience negative emotions, tension,
anxiety, and perhaps feel generally overwhelmed.

One of the biological systems that prepares our body to respond to stressors is the
hypothalamicpituitary-adrenal axis, commonly referred to as the HPA axis.

When a stressful event is experienced, we interpret the event using various brain areas. Then the
hypothalamus sends a chemical message to the pituitary glad that releases hormones that then
signal the adrenal glands to secrete cortisol, a stress hormone. Our cortisol levels vary across the
day, rising in the first 30 minutes after we wake, to help us engage with the days worth of
demands. that lie ahead. We can consider our HPA axis our slow stressor response system.

Recall from Chapter 3, our autonomic nervous system is also involved in our stress response.
The HPA axis is our slow stress response system, whereas the autonomic nervous system is
our fast stress response system. When we experience a threat, our sympathetic nervous system
is engaged. Our pupils dilate, our lungs process more oxygen, and our heart pumps more
oxygenated blood to our muscles, so that we can react quickly and efficiently. After the threat
has passed, our parasympathetic nervous system returns our body to its resting state.

Our biological systems prepare us to deal with threats in our environment, fighting the threat and
meeting the challenge, or by taking flight and fleeing the challenge.

Another type of acute stress response to threat is known as the tend-and-befriend response. It
is more common in females, and involves protecting offspring and seeking social alliances. It is
linked to the release of the hormone oxytocin a hormone associated with bonding.

Acute stress typically passes quickly. That is it has a clear onset and offset or end. In
contrast, chronic stress is characterized by a state of enduring arousal that results, when
environmental demands are perceived as exceeding one’s resources to manage those demands.
With time, chronic stress contributes to a variety of illnesses.

The general adaptation syndrome is a model that shows the progression from acute to chronic
stress and the associated consequences for health.

• In the alarm stage, the body is prepared to fight or flee.

• In the resistance stage, the defenses prepare for longer, sustained attack or challenge against the
stressor.
• If that stage persists for too long, one will enter the exhaustion stage, which is associated with
the failure of a variety of physiological and immune systems.

Think about how you feel during exam periods. As classes draw to an end, you might enter the
alarm stage, as you realize that exams are coming up soon, and you need to prepare. Then as the
exams start, you enter the resistant stage, and you persist through many days and sometimes
weeks of studying, and exam writing. Depending on how long your exam period lasts, and how
many exams you have to write, you may enter the exhaustion phase, if your resources were taxed
for too long. Has it ever happened to you that you have gotten sick right after exams? You made
it through the entire stressful period, because your defenses were maximized. And then when you
finally relaxed, your systems fail. For most people, the post exam exhaustion period is short, and
you quickly recover back to your normal resistance levels. But for people who experience
chronic stressors that persist without end, they may not fully recover.
This table summarizes how our major physiological systems are affected differently by acute vs.
chronic stress. Take a moment to review this table to understand the short and long term impacts
of stress on health.

Indeed, as we saw earlier, stress contributes to nearly every major cause of death in Canada as well
as in other developed nations.
Coping
The attempts people make to avoid, escape, or minimize the effects of a stressor is called coping.
Coping is one of the psychological factors in the biopsychosocial model that impacts health and
well-being.

Cognitive Appraisals

According to Lazarus’ theory, coping is a two-part cognitive process.

• First, we have primary appraisals. Here we decide whether a stimulus in the environment is
indeed a stressor or not.
• A secondary appraisal follows where we evaluate how to respond and choose among coping
behaviors.

Behaviours & Styles

Coping behaviors and styles fall into three general categories.

• Problem focused coping involves setting and following a plan of action to manage the
stressful situation.
• Emotion focused coping involves rumination or brooding, where a person thinks about
how badly they feel over and over again.
• Avoidance coping involves distraction.
avoidance coping is sometimes grouped under emotion focused coping because it targets or
focuses on emotions - the avoidance of negative emotions. It does not involve active problem
solving.

Positive Reappraisal

Another cognitive coping mechanism is referred to as positive reappraisal, which facilitates

positive thinking. When downward comparisons are made, people feel better, because they see
that things are not as bad as they could be.
Another form of cognitive reappraisal involves shifting one’s perspective to see the benefits or
the bright side of a situation.

Individual Differences

Individual differences, or differences between people, in coping affect our health and wellbeing.
For example, different people have different tendencies for how they appraise and perceive
stress. Similarly, different people have different styles or typical ways of coping.

These differences are related to one’s personality. People who seem to be able to rise above or
meet any challenge are sometimes referred to a hardy, or resilient, or gritty. These individuals
are sometimes likened to a dandelion that is robust, and can grow and thrive almost anywhere.
People who are hardy tend to show commitment to larger goals, perceive stress as challenging
rather than threatening, are flexible in terms of how much control they have, and are willing to
relinquish control. They are generally optimistic about the future. These tendencies lead them to
approach stressful circumstances in open and flexible ways, that allow them to adapt well to a
variety of circumstances, just like the dandelion.

Social Support & Well-being

Our social relationships and contexts are also important for health and well-being, and make up
the last aspect of the biopsychosocial model: social conditions. These conditions range from
macro conditions, like access to health care and education and poverty, to micro conditions like
the day-to-day support we receive from family, friends, and coworkers.

People with more social support experience less stress. People with larger networks experience
less stress, and people who report higher quality relationships experience less stress. This is
because social support buffers or protects against the negative effects of stress, by providing
emotional support and also tangible support to deal with stress.

• Emotional support involves listening and showing empathy for the situation.
• Tangible support involves providing direct help, like cooking or babysitting. When people
feel supported, they can cope better and feel better.