1

Chapter 15

Stress,
Health, and
Coping

Anastasia Bake
St. Clair College

© 2020 McGraw-Hill Education Limited

Chapter 15 Outline

1. The Nature of Stress

2. Gas Stress and Health
3. Vulnerability and Protective
Factors
4. Coping with Stress
5. Health Promotion and Illness
Prevention
6. Combatting Substance Abuse
7. Positive Psychology
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 The Nature Of Stress

• Psychologists have viewed stress in three different

ways:
– As a stimulus, a response, and an organism-
environment interaction.
• Stress
– Eliciting stimuli, or events that place strong demands
on us
• These situations are termed stressors
– Stress in this “stimulus” fashion when we make
statements such as
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 The Nature Of Stress

• Microstressors
– Daily hassles
• Person-situation Interaction
– Transaction between organism & environment
– Health indicators

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 The Nature Of Stress
• Stressor characteristics that increase stress responses are shown

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 Stressors

• Catastrophic events
– Occur unexpectedly
– Affect large #’s of people

• Major Negative Events

– Stressful life events

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 Measuring Stressful Life Events

• Life event scales have been widely used in life

stress research
• Life Events Scale
– Quantify stress over a given period of time
– Indicate whether a particular event occurred
– Appraisal of being positive or negative
– Indicate amount of control, predictability

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 Stress Response

• Four aspects of appraisal process

1. Primary appraisal = demands of situation
– What do I have to do?
2. Secondary appraisal = resources available to cope
– How can I cope?
3. Judgments of consequences of situation
– What are the ‘costs’ to me?
4. Personal meaning - what does the outcome imply
– What does this say about my beliefs in myself?
World?
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 Chronic Stress and the GAS

• General
Adaptation
Syndrome = GAS
– Physiological
reaction to
prolonged stress
• Three Phases
1. Alarm
2. Resistance
3. Exhaustion
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 Chronic Stress and the GAS

• Alarm - 1st phase - similar to ‘fight or flight’

– Activation of sympathetic nervous system
– Release of stress hormones - important = Cortisol
• Triggers increase in blood sugars
• Suppresses immune system
• Cannot last indefinitely
– Parasympathetic system tries to restore
homeostasis
– If stressor persists - so does response!
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 Chronic Stress and the GAS

• Resistance – 2nd phase

– Continued recruitment of resources
– Can last long time, but resources being depleted
– Eventually are no longer sufficient

• Exhaustion – 3rd phase

– Resources dangerously depleted
– Increased vulnerability to disease
– Can manifest itself with cardiovascular problems;
immune system difficulties
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 Stress and Health

• Selye
– Work inspired medical and psychological
researchers
– To explore the effects of stress on
• Physical and Psychological well-being
• Stress and Psychological Well-Being
– Some stressors are so traumatic that they can
have a strong and long-lasting psychological
impact

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 Stress and Health

• More negative life events = more psychological

distress
– But, Correlational so cannot determine causality

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 Stress and Psychological Well-Being

• Neuroticism - A personality trait

– People who are high in neuroticism have a
heightened tendency to
• Experience negative emotions and get
themselves into stressful situations through their
maladaptive behaviours
• Some stressors have long lasting psychological
impact
• More negative life events - more likely to report
psychological distress
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 Stress and Psychological Well-Being

• Post-Traumatic Stress Disorder (PTSD)

• PTSD Symptoms
– Severe anxiety, physiological arousal (the stress
response), and distress
– Painful, uncontrollable reliving of the event(s) in
flashbacks, dreams, and fantasies
– Emotional numbing and avoidance of stimuli
associated with the trauma
– intense “survivor guilt” in instances where others
were killed but the individual survived
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 Stress and Psychological Well-Being

• The Residential School Syndrome

– Result of the residential school experience
– Individuals symptoms include recurrent intrusive
memories, nightmares, flashbacks
– Increased risk of alcohol and drug abuse starting
at a very young age
– Emotional detachment, relationship difficulties
– Loss of and avoidance of cultural knowledge, and
anger management problems

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 Stress and Illness

• Stress = Increase in chronic conditions

– Arthritis, bronchitis, emphysema
– Stress can be precursor to health problems
• Stress = increased chance of health problems
• Increases with # of stressors

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 Stress and Illness

• Research has
shown that the
stress
produced by
marital conflict
can produce a
decrease in
immune
function
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 Stress and Illness

• Other Consequences
– Decrease immune function
– Demonstrated to occur within 24 hours
– Worsen pre-existing conditions
– Stress hormones contribute to blocked arteries
– Deterioration of hippocampus and memory
impairment

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 Vulnerability and Protective Factors

• Vulnerability Factors
– Increase susceptibility to stress
• What Reduces Resistance?
– Lack of support network
– Poor coping skills
– Pessimism
• Protective Factors
– Social support, coping skills, optimism

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 Vulnerability and Protective Factors

• Social Support
– Blunts impact of stress
– Sense of identity, meaning
– May prevent maladaptive ways of coping
• Enhances immune system
– Shown among cancer patients - people who talk
about negative life events

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 Vulnerability and Protective Factors

• Why do some people suffer psychological and/or

physiological distress and others do not?
• Hardiness
– Commitment - What they do is important
– Control - Control (perceived) over situation
– Challenge - Situation is a challenge not a threat
• Which is the strongest component? - Control!

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 Coping Self-Efficacy

• Belief we can successfully cope

– Specific to situation - these demands!
• Increased efficacy from:
– Previous successes
– Observing others
– Social persuasion / encouragement
– Low levels of arousal
• Shown to increase immune system
functioning
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 Optimism

• View/belief in the outcome

– Things will work out
– Realistic thinking or delusion?
• Optimists have
– Appraisal of being less helpless
– Better adjustment to negative life events
– Sense of less helplessness
– Better health

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 Personality Factors

• Type A
– High levels of competitiveness and ambition
– Can be aggressive and hostile
• Type B
– More relaxed, agreeable

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 Type A Personality

• Experience a constant sense of time urgency

• Irritable, impatience and hostility
• The owner of this appointment book died of a
heart attack shortly after the date on this
schedule

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 Finding Meaning in Stressful Life Events

• Finding meaning
• Spiritual beliefs
– Can help with effective coping
– Certain religious beliefs can have negative effect
on adjustment
– E.g., Being punished; Guilt

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 Coping With Stress

• Which strategy is best?

– Problem focused & Seeking social support
• What about emotion focused?
– Negative outcomes with
• Avoidance, denial, wishful thinking
– Positive outcomes with
• Identifying & changing irrational thought
patterns; relaxation techniques

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Coping With Stress: Three broad classes

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 Effectiveness of Coping Strategies

• Cannot always change situation!

• With little control over the situation which is
best?
• Fewer maladaptive behaviours with emotion-
focused
• No strategy works for all situations!

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 Bottling Up Feelings:
The Costs of Constraint
• Venting negative feelings may not be good for
friendships but…
• Inability to express negative feelings has costs
– Higher likelihood of cancer
• Expressing emotions in an adaptive manner
– Long-term positive consequences on health

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 Bottling Up Feelings:
The Costs of Constraint
• Research suggests that the impact of disclosure
lessens over time

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 Gender, Culture, and Coping

• Gender Differences
• Males
– Favour problem-focused approach
• Females
– Favour emotion-focused approach
• Result of socialization?

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 Gender, Culture, and Coping

• Cultural differences
• Problem focused = North Americans &
Europeans
• Emotion-focused = Asians & Hispanics

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 Health Promotion and Illness Prevention

• Health Psychology
– Recognizes the role that behaviour plays in
health maintenance
– Studies psychological and behavioural
factors in the prevention and treatment of
illness and in the maintenance of health

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 Health Promotion and Illness Prevention
• Compared to the 1900, today’s killers are strongly influenced by
behavioural factors

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 Health Promotion and Illness Prevention

• Health-related behaviours fall into two main

categories
• Health-enhancing behaviours
– Serve to maintain or increase health
• Exercise, healthy diets, safe sexual practices, regular medical
checkups, and breast and testicular self-examination
• Health-compromising behaviours
– Promote the development of illness
• Smoking, fatty diets, a sedentary lifestyle, and unprotected
sexual activity

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 How People Change:
The Transtheoretical Model
6 Major Stages
Precontemplation
• No desire to change
• Deny behaviour has negative consequences
• Feel helpless to change
Contemplation
• Perceive problem or desire for change
• Benefits outweigh costs
Preparation
• Plan of action
• Identification of conditions that affect behaviour

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 How People Change:
The Transtheoretical Model
Action
• Actively modify behaviour or environment
• Requires greatest commitment

Maintenance
• Avoid relapse; control target behaviour

Termination
• Change in behaviour is ingrained

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 Health Promotion and Illness Prevention

• Health Psychology
– Recognizes the role that behaviour plays in
health maintenance
– Studies psychological and behavioural
factors in the prevention and treatment of
illness and in the maintenance of health

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 Increasing Behaviours
That Enhance Health

• Health practices are associated with longevity

• Pattern of earlier mortality at younger age for males
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 Increasing Behaviours
That Enhance Health
• Exercise
• Sedentary lifestyle & health problems
– E.g., Heart disease, obesity
• Benefits of exercise
– Aerobic exercise
• Oxygen better utilized; lower cholesterol levels
• Moderate levels of exercise produce best results
– Physical health
– Longevity
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Increasing Behaviours
That Enhance Health
• Aerobic exercise
– Is sustained activity
• Such as jogging,
swimming, and
bicycling,
• That elevates the
heart rate and
increases the body’s
need for oxygen

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 Reducing Behaviours That Impair Health

• Behavioural interventions
– Self-monitoring & self-regulation
– Behavioural self-regulation
• Self-monitoring
– Identify antecedents of behaviour
• Reinforcement for successes
• Exercise
– Increases positive effects

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 Prevention Programs

• Prevention Programs: AIDS

• 4 Basic features
– Education
– Motivation
– Specific guidelines
– Support
• Challenge
– Irrational sense of invulnerability among
adolescents & young adults
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 Combatting Substance Abuse

• Substance abuse exacts an enormous toll on

society
• According to the World Health Organization
– 3 million deaths every year are the result of the
misuse of alcohol

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 Combatting Substance Abuse

• The total cost of $14.6

substance use in
Canada is estimated to
be $38.4 billion $2.8
$38.4 $12
billion
– Alcohol - $14.6 billion
– Tobacco - $12 billion
– Opioids - $3.5 billion $3.5

– Cannabis - $2.8 billion

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Combatting Substance Abuse

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 Psychological Approaches to
Treatment and Prevention
• Motivational Interviewing
– Goal: Lead person to their own conclusion
– Process: Question discrepancies between current
state & self-image, behaviours
– Counsellor: Provides guidelines, feedback

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 Psychological Approaches to
Treatment and Prevention
• Multimodal Treatment Approaches
– Combination of techniques
– Can include
• Biological measures
• Learning techniques
• Stress management
• Coping skills
• Counselling

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 Psychological Approaches to
Treatment and Prevention
• Effectiveness of treatments show varying
results
– 65% for alcohol abuse up to 1 year later
• Long-term outcomes
– 30% for alcohol, smoking, other substances
• Relapse Prevention
– Relapse = return to undesirable behaviour Lapse =
‘one-time’ slip

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Psychological Approaches to
Treatment and Prevention

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 Psychological Approaches to
Treatment and Prevention
• What causes relapse?
– Insufficient coping skills
– Lack of self-efficacy
– Expected positive benefits from substance
• Abstinence violation effect
– Self-blame & guilt reinforce sense of helplessness

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Psychological Approaches to
Treatment and Prevention
• Harm Reduction
Approaches to
Prevention
• Significant positive
effects
• Seen with brief
interventions on
binge drinking

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 Psychological Approaches to
Treatment and Prevention
• Harm Reduction
• Goal is not to eliminate behaviour but to
reduce harmful effects
– Methadone, reduction of binge drinking, needle
exchange programs

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 Positive Psychology

• The term “positive psychology”

– Was first used by the humanistic psychologist
Abraham Maslow (1954)
• Current usage and meaning is based on
– Martin Seligman’s
• Since the 1950s psychology has focused too
strongly on pathology—on treating illness

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 Positive Psychology

• Positive psychology
– Uses the scientific method and the research tools
that psychologists have developed to study human
behaviour
– Focus on positive experience and well-being
• Does not mean that psychology should ignore
negative experience and illness

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 Positive Psychology

• Psychological research-derived • Set meaningful personal

suggestions that may help you goals, and make progress
maintain and enhance toward them
personal happiness:
• Make time for enjoyable
• Spend time with others, activities
and work to develop close • Nurture physical well-being
relationships
• Be open to new
• Look for ways to be experiences
helpful to others, and • Cultivate optimism, and
reach out to the less count your blessings
fortunate
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 Chapter 15 Summary and Evaluation

• The Nature of Stress

– Stressors
– The Stress Response
– Chronic Stress and the

• Gas Stress and Health

– Stress and Psychological Well-Bein
– Post-Traumatic Stress Disorder (PTSD)
– Stress and Illness
© 2020 McGraw-Hill Education Limited 60
 Chapter 15 Summary and Evaluation

• Vulnerability and Protective Factors

– Social Support
– Hardiness
– Coping Self-Efficacy
– Optimism
– Personality Factors
– Finding Meaning in Stressful Life Events

© 2020 McGraw-Hill Education Limited 61

 Chapter 15 Summary and Evaluation

• Coping with Stress

– Effectiveness of Coping Strategies
– Bottling Up Feelings: The Costs of Constraint
– Gender, Culture, and Coping

© 2020 McGraw-Hill Education Limited 62

 Chapter 15 Summary and Evaluation

• Health Promotion and Illness Prevention

– How People Change: The Transtheoretical Model
– Increasing Behaviours That Enhance Health
– Reducing Behaviours That Impair Health
• Combatting Substance Abuse
– Psychological Approaches to Treatment and
Prevention
• Positive Psychology

© 2020 McGraw-Hill Education Limited 63