Coping with Chronic Illness: Stress and Intervention
What is stress?
-Is stress only due to things that happen to us?
-Without stressors in the environment, life would be easy.
-No, of course not.
-There are always stressors in life
-Stressors only become meaningful through appraisal
-Normal to experience stress
-If stress is chronic it can be damaging to health
What is Stress?
-Stress traditionally conceptualised as “major life events” (rank order):
1. Death of a spouse
3. Marital separation => Chronic (Physical) Illness
4. Jail Term
5. Death of a relative
The Transactional Model
-Lazarus and Folkman (1984) proposed life events cause chronic daily
“hassles” = minor unpleasant events (acute)
-Acute Stress Disorder Criteria
A. Anxiety following a traumatic stressor (eg, an earthquake)
B. Intrusive memories or dissociation (surreal or amnesia) and
hypervigilance or avoidance (place or thoughts)
C. Lasting for 3 days to 1 month after the traumatic even (>1
month= possible post-traumatic stress disorder)
D. Clinically significant distress or impairment
E. Not due to a substance, head injury, or brief psychosis.
-Modelled stress as an ongoing process of transaction between the individual
and their environment.
-The individual makes appraisals of:
-The situation = primary appraisals
-How able they are to cope = secondary appraisals
What is an appraisal?
-The two appraisals within the transactional model are:
-Primary (stress) appraisals:
-Harm: the negative outcomes experienced so far
-Threat: potential negative outcomes
-Challenge: potential positive outcomes -Secondary (coping ability) appraisals:
-Self: can I cope?
-Help: who can help me cope?
Stress and Coping when sick
-Harm: This symptom is unbearable
-Threat: Maybe something’s really wrong
-Challenge: I had shed loads of sick days I can use
-Self: I don’t know if I can cope – I’ve never felt this ill
-Potential help: I’ll ask mum
-Professional help: Maybe I should see my GP. Or google it.
Ways of Coping
-Three main types of coping effort:
-Problem-focused (usually active and approach in nature)
-Emotion-focused (often passive and avoidant in nature)
-Meaning-focused (also passive but approach -> growth)
-Hard to categorise a specific coping activity
-What about seeking advice from a close friend?
-May involve focusing on the problem
-May also involve help dealing with emotions
Rheumatoid Athritis (RA): Reminder
-Affects 1 in 100 people (more women)
- Can onset at any age
-Autoimmune – sometimes controllable by medication
-Cyclical – chron