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Chapter Midterm

Health Psychology Exam 2 Notes - Chapter 6, 7, 8, 9, and 10

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York University
PSYC 3170
Jennifer Mills

Health Psychology Exam 2 Notes Chapter 6 – Stress What Is Stress?  Stress – a negative emotional experience accompanied by predictable biochemical, physiological, cognitive, and behavioural changes that are directed either toward altering the stressful event or accommodating to its effects What Is a Stressor?  A stressor is stressful event Person-Environment Fit  Stress is the consequence of a person’s appraisal processes  The assessment of whether personal resources are sufficient to meet the demands of the environment  Stress is determined by person-environment fit  Stress results from the process of appraising events (as harmful, threatening, or challenging), of assessing potential responses, and of responding to those events What Theories and Models Are Used to Study Stress? Fight-or-Flight  When an organism perceives a threat, the body is rapidly aroused and motivated via the sympathetic nervous system and the endocrine system  Attack or flee  Now more commonly fight refers to aggressive responses to stress, whereas flight may be seen in social withdrawal or withdrawal through substance use such as alcohol or drugs Selye’s General Adaptation Syndrome  Selye considered father of stress research  Exposed rates to stressors, all created similar physiological response  When an organism confronts a stressor, it mobilizes itself for action  The response is nonspecific in regards to the stressor  Regardless of the threat, responds with the same physiological response  Over time, with repeated or prolonged exposure to stress, there will be wear and tear on the system  General adaptation syndrome consists of three phases  Alarm: the organism becomes mobilized to meet the threat  Resistance: the organism makes efforts to cope with the threat, as through confrontation 1  Exhaustion: occurs if the organism fails to overcome the threat and depletes its physiological resources in the process of trying  Assigns limited role to psychological factors, reason to criticize, know that appraisal plays a major role  Not all stressors produce same effect Tend-and-Befriend  Animals, human or nonhuman, don’t just fight, flee or become exhausted  Affiliate with each other  Tend-and-befriend theory maintains that in addition to fight-or-flight, humans respond to stress with social and nurturant behaviour  Especially true for women  Affiliate with others, seek social contact, befriend during times of stress Psychological Appraisal and the Experience of Stress  In humans, psychological appraisals are an important determinant of whether an event is responded to as stressful Primary Appraisal Processes  When individuals confront a new or changing environment, they engage in a process of primary appraisal to determine the meaning of the event  Events may be perceived as positive, neutral, or negative in their consequences  Negative events are further appraised for their possible harm, threat, or challenge  Harm is the assessment of the damage that has already been done by an event  Threat is the assessment of possible future damage  Challenge is the potential to overcome and event profit from the event Secondary Appraisal Processes  Secondary appraisal is the assessment of one’s coping abilities and resources and whether they will be sufficient to meet the harm, threat, and challenge of the event  Subjective experience of stress is a balance between primary and secondary appraisal  Harm and threat high, coping ability low, substantial stress is felt The Physiology of Stress  Stress causes physiological distress and leads to changes in the body that may have short or long term consequences for health  Two main systems involved  Sympathetic-adrenomedullary (SAM) system and the hypothalamic- pituitary-adrenocortical (HPA) axis 2 Sympathetic Activation  Threatening events labeled by the cerebral cortex, which sets off chain of reactions  Cortex to hypothalamus, which arouses sympathetic nervous system (fight or flight)  Sympathetic arousal stimulates the medulla of the adrenal glands, which in turn secret catecholamines, epinephrine and norepinephrine HPA Activation  Nonspecific physiological reaction (general adaptation syndrome) occurs in response to stress and involves three phases of alarm, resistance, and exhaustion  Hypothalamus stimulates pituitary gland to secret ACTH, which stimulates adrenal cortex to release glucocorticoids  Cortisol especially significant, conserve stores of carbohydrates and reduce inflammation in the case of an injury  HPA repeatedly activated leads to altered daily cortisol patterns, usually high upon wakening and decreases over the day  People under chronic stress show high cortisol levels in the afternoon or evening Effects of Long-term Stress  Excessive discharge of epinephrine and norepinephrine can lead to suppression of immune functions  Increased BP and heart rate  Variations in normal heart rate  Neurochemical imbalances  Prolonged cortisol secretion can lead to problems in verbal functioning, memory, and concentration Individual Differences in Stress Reactivity  People vary in their reactivity to stress  Reactivity is the degree of change that occurs in autonomic, neuroendocrine, and/or immune responses as a result of stress  Some people show very small reactions to stressful circumstances, other show large responses  May be genetic or develop prenatally or early in life  More reactive to stress, often more vulnerable to disease Physiological Recovery Processes  Inability to recover quickly from a stressful event may be a marker for the cumulative damage that stress has caused 3 Allostatic Load  Allostatic load refers to the fact that physiological systems within the body fluctuate to meet demands from stress, a state called allostasis  Allostatic load builds up over time, defined as the physiological costs of chronic exposure to heightened neural response that results from chronic stress What Makes Events Stressful? Assessing Stress  Self reports, life change, emotional distress, behavioural measures, physiological measures, biochemical markers Dimensions of Stressful Events  What are characteristics of potential stressors that make them more likely to be appraised as stressful? Negative Events  Negative events more likely to produce stress than positive events Uncontrollable Events  Uncontrollable or unpredictable events are more stressful than controllable or predictable events Ambiguous Events  Ambiguous events more stressful than clear cut events  No opportunity to take action, must increase energy to understand situation Which Stressors?  People more vulnerable to stress in central life domains than in peripheral ones  Important aspects of the self are overly invested in central life domains Can People Adapt to Stress?  Will people eventually habituate to constant stress or will they develop chronic strain?  Depends on type of stressor, the subjective experience of stress, and which indicator of stress is considered Psychological Adaptation  Most people are able to adapt psychologically to moderate or predictable stressors  Vulnerable populations (children, elderly, poor) adversely affected by environmental stressors  Show signs of helplessness and difficulty in performing tasks  People show signs of both long-term strain and habituation to chronically stressful events 4 Physiological Adaptation  Animal models suggest both habituation and chronic strain in terms of physiological adaptation Must a Stressor Be Ongoing to Be Stressful?  Unlike lower animals, humans do not have to be exposed to a stressor to suffer stress Anticipating Stress  Anticipation of a stressor can be at least as stressful as its actual occurrence, and often more so After-effects of Stress  Adverse after-effects of stress, such as decreases in performance and attention span, are also well documented  Effects of stress often persist long after the stressful event itself  Reserves are drained and resistance breaks down How Has Stress Been Studied? Studying Stress in the Laboratory  Acute stress paradigm – participant goes through short-term stressful events, changes in emotions and physiological and/or neuroendocrine processes are assessed Inducing Disease  Expose people to viruses, assess whether they get ill or how ill they get Daily Stress  Daily minor problems reduce psychological well-being over the short term and produce physical symptoms  Hassles scale What Are The Sources of Chronic Stress? Stress in the workplace Physical Hazards Work overload Ambiguity and Role Conflict  Role ambiguity occurs when a person has few clear ideas of what is to be done and no idea of the standards used for evaluating work  Role conflict occurs when a person receives conflicting information about work tasks or standards from different individuals Social Relationships 5  Inability to develop social relationships at work has been tied to psychological distress at work  Social relationships also buffer other job stressors Lack of control over work has been related to a number of stress and illness indicators Job Insecurity Unemployment Chapter 7 – Moderators of the Stress Experience What Is Coping?  Coping is defined as the thoughts and behaviours used to manage the internal and external demands of situations that are appraised as stressful  Relationship between coping and a stressful event is a dynamic process  Coping is a set of responses, occurring over time, by which the environment and the person influence each other Personality and Coping  Personality that each individual brings to a stressful event influences how he or she will cope with that event  Certain personality factors can make stressful situations worse, whereas others improve them Negativity, Stress, and Illness  Negative affectivity – a pervasive negative mood marked by anxiety, depression, and hostility  Individuals high in negative affectivity, or neuroticism, express distress, discomfort, and dissatisfaction across a wide range of situations  Correlated with illness and poor health  Can be associated with elevated cortisol secretion  Often linked with believing they’re sick, when there is no real reason for their illness  Individuals who are chronically high in negative affect may be more likely to get sick, but also show physical symptoms and illness behaviour even when they are not getting sick Pessimism  Pessimism viewed as a relatively stable dispositional characteristic to expect negative outcomes in the future  People with a pessimistic explanatory style explain the negative events of their lives in terms of internal, stable, global qualities of themselves  Lays ground work for poor health Perfectionism  Linked to several negative health outcomes 6  Social perfectionism, believing everyone expects you to be perfect, is more linked with negative health  Self-oriented perfectionism, setting high personal standards which motivate achievement, is not linked with poor health Coping Resources Optimism  Optimistic nature can lead people to cope more effectively with stress, and reduce risk for illness  Dispositional optimism is a general expectancy that good things, not bad, will happen in the future  Positive mood may lead to state of physiological resistance  Positive emotional states associated with better physical and mental health Psychological Control  Feelings that one can exert control over stressful events have long been known to help people cope effectively with stress  Psychological control is the belief that one can determine one’s own behaviour, influence one’s environment, and bring about desired outcomes  Similar to self-efficacy  Help cope with a wide variety of stressful events Additional Coping Resources  High self-esteem  Ego strength; a cluster of qualities including dependability, trust, and lack of impulsivity  Self confident, easy going  Conscientiousness Coping Style  Coping style represents a more specific individual difference in how people respond to stress  Coping style is a general propensity to deal with stressful events in a particular way  Could be keeping quiet, or talking about it Approach versus Avoidance  Avoidant (minimizing) coping style  Approach (confrontational, or vigilant) coping style  Neither is more effective, each has advantages and liabilities  Approach related is most successful if one can focus on the information present in the situation rather than on one’s emotions  Avoidant is better for short-term stress, not for persistent stressful situations 7 Problem-focused versus Emotion-focused Coping  Can be distinguished according to the target of the coping efforts  Problem-focused coping involves attempts to do something constructive about the stressful conditions  Emotion-focused coping involves efforts to regulate emotions experience because of the stressful event  People use both, both are useful What Are External Coping Resources?  Having greater resources provides people with opportunity to cope with stressful events better  Time, money, friends, and other resources provide more ways of dealing with a stressful event What Are Coping Outcomes  Coping efforts center on five main tasks 1. To reduce harmful environmental conditions and enhance the prospects of recovery 2. To tolerate or adjust to negative events or realities 3. To maintain a positive self-image 4. To maintain emotional equilibrium 5. To continue satisfying relationships with others  A person may be said to have coped successfully to the extent that these tasks are successfully addressed  Coping outcomes have also included measures of physiological and biochemical functioning  Coping efforts are generally judge to be more successful if they reduce arousal  Another criterion of successful coping is whether and how quickly people can return to their pre-stress activities  Also researchers judge coping according to its effectiveness in reducing psychological distress How Does Social Support Affect Stress? What Is Social Support?  Social support – information from others that one is loved and cared for  High levels of social support, experience less stress  Tangible assistance – the provision of material support, such as services, financial assistance, or goods  Informational support  Emotional support – reassuring the person that he or she is a valuable individual who is cared for  Many of the benefits of social support may actually come from the perception that social support is available 8  Invisible support – one receives help from another, but is unaware of it, that help is most likely to benefit the self Implicit versus Explicit Social Support  Explicit social support – designed to target a specific problem or is meant for a specific purpose  Takes one of the three different forms of tangible, informational, or emotional support  Implicit social support – social support originates from implicit social networks without being directly targeted at a specific problem  Simply knowing you have a social network that you can rely upon  Asians less likely to seek out or benefit from explicit social support Moderation of Stress by Social Support  Two possibilities explain the role of social support in moderating the effects of stress  Direct effects hypothesis – social support is generally beneficial during nonstressful times as well as during highly stressful times  Buffering hypothesis – the health and mental health benefits of social support are chiefly evident during periods of high stress; when there is little stress, social support may have minimal health benefits What Kinds of Support Are Most Effective  Sometimes support is unwanted  Too much or overly intrusive social support may exacerbate stress Dyadic Coping  Dyadic coping – the interplay of the stress experienced by one partner and the coping reactions of the other, can have important implications for the outcomes of both Matching Support to the Stressor  Matching hypothesis – match between one’s needs and what one receives from others in one’s social network What Are Coping Interventions? Mindfulness Training  Mindfulness-based stress reduction (MBSR) – systematic training in meditation to assist people in self regulating their reactions to stress and any negative emotions that may result  Practice of mindfulness of moment or moment awareness  Enables people to become more aware of the present moment and less distracted by distressing thoughts and feelings 9 Disclosure and Coping  Beneficial to discuss feelings and perceptions, reduce the physiological activity associated with the event Chapter 8 – Using Health Services How Do We Recognize and Interpret Symptoms? Recognition of a Symptom Individual Differences and Personality  Hypochondriacs are people who are preoccupied and worried that normal bodily symptoms are indicators of illness  Most frequent symptoms that show up among patients who convert their distress into physical symptoms are back pain, joint pan, head ache  Older people report more symptoms than young people  Neuroticism, a pervasive dimension of personality marked by negative emotions, self consciousness, and a concern with bodily processes  People who are high in neuroticism recognize their symptoms more quickly, report their symptoms more quickly, or both Cultural Differences  Japanese women report less symptoms related to menopause Situational Factors  A boring situation makes people more attentive to symptoms than an interesting situation does  Medical students’ disease – study each illness, members of the class imagine they have it Stress  People under stress may believe that they are more vulnerable to illness and so attend more closely to their bodies Mood  People in a positive mood rate themselves as more healthy  Report fewer illness-related memories, report fewer symptoms Interpretation of Symptoms Prior Experience  Interpretation of symptoms is heavily influenced by prior experience  People who have experience with a medical condition estimate the prevalence of their symptoms to be greater and often regard the condition as less serious than do people with n
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