Copyright © 2010 Pearson Education Canada15-1 Health, Stress, and Coping Chapter 15.

Copyright © 2010 Pearson Education Canada 15-1

Health, Stress, and CopingHealth, Stress, and Coping

Chapter 15Chapter 15


Chapter OutlineChapter Outline

• The Stress-Illness MysteryThe Stress-Illness Mystery

• The Physiology of StressThe Physiology of Stress

• The Psychology of StressThe Psychology of Stress

• Coping with StressCoping with Stress

• How Much Control Do We Have Over Our How Much Control Do We Have Over Our Health?Health?


Health & StressHealth & Stress

• Health psychologyHealth psychology

– Studying the biological, psychological, social, and Studying the biological, psychological, social, and cultural factors that influence health and illnesscultural factors that influence health and illness

• What is stress?What is stress?

– Subjective experience that can include sudden Subjective experience that can include sudden traumatic experiences, continuing pressures that seem traumatic experiences, continuing pressures that seem uncontrollable, & small irritations that wear you downuncontrollable, & small irritations that wear you down


Measuring StressMeasuring Stress

• Daily stressors or Daily stressors or hassleshassles can add up to can add up to significant stress over timesignificant stress over time

– People tend to seek help for major life events People tend to seek help for major life events and not hassles, which helps to explain and not hassles, which helps to explain detrimental effectdetrimental effect

• Stressfulness of life events may be rated by Stressfulness of life events may be rated by using using Social Readjustment Rating Scale Social Readjustment Rating Scale (SRRS)(SRRS)


Stress-Illness MysteryStress-Illness Mystery

• Stressors:Stressors: stressful experiences or situations stressful experiences or situations

• Common stressors:Common stressors:

– Work-related problemsWork-related problems– NoiseNoise– Bereavement and lossBereavement and loss– Poverty, powerlessness, and low statusPoverty, powerlessness, and low status– Recent immigrationRecent immigration



• Chronic stress lasting a month or more boosts Chronic stress lasting a month or more boosts the risk of catching a coldthe risk of catching a cold



• No direct relationship between chronic No direct relationship between chronic stressors and illnessstressors and illness

– Doesn’t affect everyone the same wayDoesn’t affect everyone the same way

• Three factors that influence responses to Three factors that influence responses to stressors:stressors:

1.1. Individual physiological differencesIndividual physiological differences2.2. Psychological factorsPsychological factors3.3. People’s behaviour under stressPeople’s behaviour under stress


Physiology of StressPhysiology of Stress

• General adaptation syndromeGeneral adaptation syndrome (Hans Selye) (Hans Selye)

– A series of physiological responses to stressors that A series of physiological responses to stressors that occur in three stages: alarm, resistance, and occur in three stages: alarm, resistance, and exhaustionexhaustion

1.1. Alarm PhaseAlarm Phase

– Body mobilizes the sympathetic nervous system to deal Body mobilizes the sympathetic nervous system to deal with immediate threatwith immediate threat

– Release of adrenal hormonesRelease of adrenal hormones



• Alarm phase corresponds to the Alarm phase corresponds to the fight or flightfight or flight responseresponse



2.2. Resistance PhaseResistance Phase

– Body attempts to resist or cope with stressor that Body attempts to resist or cope with stressor that cannot be avoidedcannot be avoided

– Physiological alarm responses occur but increase Physiological alarm responses occur but increase vulnerability to other stressorsvulnerability to other stressors

3.3. Exhaustion PhaseExhaustion Phase

– Persistent stress depletes the body of energyPersistent stress depletes the body of energy– Increased vulnerability to physical problems & illnessIncreased vulnerability to physical problems & illness


Stress & the BodyStress & the Body

• HPA (hypothalamus-pituitary-adrenal cortex) axisHPA (hypothalamus-pituitary-adrenal cortex) axis

– A system activated to energize the body to respond A system activated to energize the body to respond to stressors (crucial for short-term stress responses)to stressors (crucial for short-term stress responses)

– Hypothalamus sends chemical messengers to the Hypothalamus sends chemical messengers to the pituitarypituitary

– Pituitary then prompts the adrenal cortex to produce Pituitary then prompts the adrenal cortex to produce cortisol and other hormonescortisol and other hormones



Mind-Body LinkMind-Body Link

• Psychoneuroimmunology (PNI)Psychoneuroimmunology (PNI)

– The study of the relationships among psychology, the The study of the relationships among psychology, the nervous and endocrine systems, & the immune systemnervous and endocrine systems, & the immune system

– Study antigens, which are white blood cells designed to Study antigens, which are white blood cells designed to recognize foreign or harmful substances & destroy themrecognize foreign or harmful substances & destroy them

– Chronic stress can weaken or suppress the immune Chronic stress can weaken or suppress the immune system (feelings of stress can be as important as actual system (feelings of stress can be as important as actual stress)stress)


Psychology of StressPsychology of Stress

• What is the role of psychological factors in What is the role of psychological factors in stress and health?stress and health?

– Personality Personality notnot linked to risk of cancer linked to risk of cancer

– Negative emotions can influence course of Negative emotions can influence course of illness and recovery once a person has some illness and recovery once a person has some type of disease or virus type of disease or virus

– Negative emotions do not Negative emotions do not causecause illness, with a illness, with a few exceptionsfew exceptions


Hostility & DepressionHostility & Depression• Cynical & antagonistic hostility increases Cynical & antagonistic hostility increases

risk of heart diseaserisk of heart disease

• Clinical depression also linked increased Clinical depression also linked increased risk of heart attackrisk of heart attack


Positive EmotionsPositive Emotions

• Positive emotions can have healthful benefitsPositive emotions can have healthful benefits

– Longitudinal study of 180 Catholic nuns found that Longitudinal study of 180 Catholic nuns found that longevity was related to frequency of positive emotionslongevity was related to frequency of positive emotions

– Positive emotions may counteract high arousal caused Positive emotions may counteract high arousal caused by negative emotions/chronic stressorsby negative emotions/chronic stressors

– May be associated with more social support and May be associated with more social support and creative problem solvingcreative problem solving


Managing Negative EmotionsManaging Negative Emotions

• SuppressionSuppression of negative emotions can have of negative emotions can have detrimental health effectsdetrimental health effects– E.g., decreased levels of white blood cellsE.g., decreased levels of white blood cells

• Studies on lonelinessStudies on loneliness

– Social (longing for friendships) versus emotional Social (longing for friendships) versus emotional (longing for significant others) loneliness(longing for significant others) loneliness

– Eating patterns changed when people were lonelyEating patterns changed when people were lonely– Lonely individuals may discourage relationships by Lonely individuals may discourage relationships by

judgmental attitudes (towards self & others)judgmental attitudes (towards self & others)– Men may be lonelier than women (inhibited expression)Men may be lonelier than women (inhibited expression)


Benefits of Confession & Letting GoBenefits of Confession & Letting Go

• Confession (divulging private thoughts that make Confession (divulging private thoughts that make you ashamed or depressed) linked to better healthyou ashamed or depressed) linked to better health

• Forgiveness Forgiveness as a strategy as a strategy to let go of to let go of grudges grudges linked to linked to better better physical physical outcomesoutcomes


Optimism & PessimismOptimism & Pessimism

• OptimismOptimism – general expectation that things will go – general expectation that things will go well despite setbacks – associated with better well despite setbacks – associated with better health relative to pessimists:health relative to pessimists:

• Optimists tend to:Optimists tend to:

– Live longer (lower HPA activation in response to stress)Live longer (lower HPA activation in response to stress)– Be active problem-solversBe active problem-solvers– Don’t give up or escapeDon’t give up or escape– Keep a sense of humourKeep a sense of humour


The Sense of ControlThe Sense of Control

• Locus of controlLocus of control

– A general expectation about whether the results A general expectation about whether the results of your actions are under your own control of your actions are under your own control (internal locus) or beyond your control (external (internal locus) or beyond your control (external locus)locus)

• Feelings of control can reduce or even Feelings of control can reduce or even eliminate the relationship between eliminate the relationship between stressors and healthstressors and health


Benefits of ControlBenefits of Control

• Lower frequency of developing colds (when exposed to Lower frequency of developing colds (when exposed to viruses) when feel in control of lifeviruses) when feel in control of life

• Low or high-incomes associated with similar levels of well-Low or high-incomes associated with similar levels of well-being among those who feel in controlbeing among those who feel in control

• Managers and executives have fewer illnessesManagers and executives have fewer illnesses

• Professionals who belong to visible minorities & feel more Professionals who belong to visible minorities & feel more in control of their situations are at a lower risk of in control of their situations are at a lower risk of hypertensionhypertension

• Nursing home residents with greater control over activities Nursing home residents with greater control over activities are more alert, happier and live longerare more alert, happier and live longer


Limits of ControlLimits of Control

• Differing cultural views on controlDiffering cultural views on control

– Primary control:Primary control: an effort to modify reality by an effort to modify reality by changing other people, the situation, or eventschanging other people, the situation, or events

• ““fighting back” philosophy; Western viewfighting back” philosophy; Western view

– Secondary control:Secondary control: an effort to accept reality by an effort to accept reality by changing your own attitudes, goals or emotions changing your own attitudes, goals or emotions

• ““learn to live with it” philosophy; Eastern viewlearn to live with it” philosophy; Eastern view


Coping with StressCoping with Stress

• Coping:Coping: Actively trying to manage demands that Actively trying to manage demands that feel stressfulfeel stressful

• Some people succumb to adversity, whereas Some people succumb to adversity, whereas others survive, are resilient, or thrive (learn from others survive, are resilient, or thrive (learn from experiences)experiences)


Cooling OffCooling Off

• Most immediate way to handle stress is to Most immediate way to handle stress is to calm down & reduce arousalcalm down & reduce arousal

• Progressive relaxationProgressive relaxation

– Alternately tensing and relaxing the muscles, Alternately tensing and relaxing the muscles, from toes to headfrom toes to head

• Other effective cooling off strategies include Other effective cooling off strategies include massage therapy, physical fitness, or massage therapy, physical fitness, or engaging in an activity you enjoyengaging in an activity you enjoy


Physical FitnessPhysical Fitness

• Studies have found that Studies have found that people who are people who are physically fit have fewer physically fit have fewer health problems than health problems than those who are not when those who are not when experiencing the same experiencing the same pressurespressures

• Less anxious, Less anxious, depressed, irritable, & depressed, irritable, & fewer physical symptomsfewer physical symptoms


Solving the ProblemSolving the Problem

• Emotion-focused copingEmotion-focused coping– Dealing with a problem by concentrating on the emotions Dealing with a problem by concentrating on the emotions

the problem has caused, whether anger, anxiety, or griefthe problem has caused, whether anger, anxiety, or grief

• Problem-focused copingProblem-focused coping– Dealing with a problem by solving the problem itselfDealing with a problem by solving the problem itself

• Often move from emotion- to problem-focused Often move from emotion- to problem-focused coping over time & depending on nature of coping over time & depending on nature of problemproblem


Rethinking the ProblemRethinking the Problem

• Three effective cognitive coping methods:Three effective cognitive coping methods:

1.1. Reappraising the situationReappraising the situation– Reappraisal:Reappraisal: thinking about problem differently thinking about problem differently

2.2. Learning from the experienceLearning from the experience

3.3. Making social comparisonsMaking social comparisons– Social comparison:Social comparison: compare self to others who compare self to others who

are believed to be less fortunateare believed to be less fortunate


Social SupportSocial Support

• Social supportSocial support– Assistance from others in your network of family, friends, Assistance from others in your network of family, friends,

neighbours, and co-workersneighbours, and co-workers

• Friendships can reduce the risk of health problemsFriendships can reduce the risk of health problems– Associated with fewer colds, less harmful stress Associated with fewer colds, less harmful stress

reactions, and longer livesreactions, and longer lives

• Social support may enhance health because it Social support may enhance health because it bolsters the immune system (greater sense of bolsters the immune system (greater sense of control & optimism)control & optimism)


Hugs & HealthHugs & Health

• Under stress, Under stress, women who got women who got a supportive a supportive touch from their touch from their close partner close partner resulted in a resulted in a reduced stress reduced stress response in the response in the hypothalamushypothalamus


Social Support & MenSocial Support & Men

• Social support good for male heart & oxytocin Social support good for male heart & oxytocin levels (but men are less likely to seek out support)levels (but men are less likely to seek out support)

• When do men seek out help?When do men seek out help?

– The problem is perceived as normal & common rather The problem is perceived as normal & common rather than something he alone suffers fromthan something he alone suffers from

– The problem is not central to the man’s self-conceptThe problem is not central to the man’s self-concept– The man feels able to reciprocate the helpThe man feels able to reciprocate the help– Other men support the decision to seek helpOther men support the decision to seek help


Coping & FriendsCoping & Friends

• Sometimes friends may be the source of Sometimes friends may be the source of unhappiness, stress & angerunhappiness, stress & anger

– Responsibilities of women in middle age in caring Responsibilities of women in middle age in caring for others (family & aging parents)for others (family & aging parents)

– Married couples who argue in a hostile way have Married couples who argue in a hostile way have increased elevations of stress hormones and increased elevations of stress hormones and immune deficiencyimmune deficiency

• Friends may be unsupportive or block your Friends may be unsupportive or block your progress toward a goalprogress toward a goal


Healing Through HelpingHealing Through Helping

• Giving support to others is another way to Giving support to others is another way to cope with stresscope with stress

• People gain strength by focusing less on People gain strength by focusing less on their own problems and helping other people their own problems and helping other people overcome theirsovercome theirs

– Associated with increased longevityAssociated with increased longevity

– Stimulates optimism and restores sense of Stimulates optimism and restores sense of control (encourages problem-solving)control (encourages problem-solving)


Coping with StressCoping with Stress


Control Over HealthControl Over Health

• Link between stress & illness not straightforwardLink between stress & illness not straightforward– Depends on many risk and protective factorsDepends on many risk and protective factors

• Most of us aware of the benefits of health-Most of us aware of the benefits of health-promoting behaviourspromoting behaviours

– Interestingly, those who know the most about Interestingly, those who know the most about specific risky behaviours (e.g., unprotected sex & specific risky behaviours (e.g., unprotected sex & spread of HIV) may be less likely to stop these spread of HIV) may be less likely to stop these behavioursbehaviours


Risk FactorsRisk Factors


Control Over HealthControl Over Health

• Leading causes of death in Canada Leading causes of death in Canada (cardiovascular disease & cancer) are largely (cardiovascular disease & cancer) are largely preventablepreventable

• Social & cultural contexts may be involved with Social & cultural contexts may be involved with individuals who engage in unhealthy lifestylesindividuals who engage in unhealthy lifestyles

– Exposure to role models or peer pressureExposure to role models or peer pressure

– Genetic components (e.g., alcoholism)Genetic components (e.g., alcoholism)

– Social norms & traditional gender rolesSocial norms & traditional gender roles


Reducing Risky BehavioursReducing Risky Behaviours

• How do we reduce risky behaviours?How do we reduce risky behaviours?

– Knowledge isn’t enoughKnowledge isn’t enough

– Change beliefs of individual; instill self-related Change beliefs of individual; instill self-related motivation to change rather than trying to motivation to change rather than trying to please othersplease others

– Subtle remindersSubtle reminders• E.g., hand stamps saying “AIDS KILLS” effective at E.g., hand stamps saying “AIDS KILLS” effective at

reducing risky sexual behaviours (MacDonald et al., reducing risky sexual behaviours (MacDonald et al., 2000)2000)


Are There Limits to Control?Are There Limits to Control?

• Some people say health should be dealt with as Some people say health should be dealt with as “mind over matter”“mind over matter”

– Oversimplified message that factors producing good Oversimplified message that factors producing good health are entirely psychological or under our controlhealth are entirely psychological or under our control

• Three strongest predictors of longevity & health Three strongest predictors of longevity & health that are under our control: that are under our control: not smoking, eating a not smoking, eating a healthful diet, and exercising regularlyhealthful diet, and exercising regularly

• Successful coping does not mean eliminating all Successful coping does not mean eliminating all stress (impossible!)stress (impossible!)


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Copyright © 2010 Pearson Education Canada15-1 Health, Stress, and Coping Chapter 15.

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