Ch 13 Stress and Health - Last unit PDF

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Ch 13 Stress and Health Life has its stressors, specific events or chronic pressures that place demands on a person or threaten the person’s well-being. Although such stressors rarely involve threats of death, they do have both immediate and cumulative effects that can influence health. This chapter will look at psychologist and physicians have learned about the kinds of life events that produce stress, the physical and psychological response to internal and external stressors, typical responses to such stressors; and ways to manage stress. Stress has a profound influence on health that we consider stress and health together in this chapter. We will consider the more general topic of health psychology, the subfield of psychology concerned with ways psychological factors influence the causes and treatment of physical illness and the maintenance of health. 1. Sources of Stress: What Gets to You a. Stressors are personal events that affect the comfortable pattern of our lives and little annoyances that bug us day after day. b. Stressful Events i. People often seem to get sick after major life events. ii. Compared with negative events, positive events produce less psychological distress and fewer physical symptoms. However, positive events often require readjustments and preparedness that many people find extremely stressful, so these events are included in computing life-change scores. c. Chronic Stressors i. Life would be simpler if an occasional stressful event such as a wedding or a lost job were the only pressure we faced. At least each event would be limited in scope, with a beginning, a middle, and, ideally, an end. ii. But unfortunately, life brings with it continued exposure to chronic stressors, sources of stress that occur continuously or repeatedly. iii. People who report being affected by daily hassles also report more psychological symptoms and physical symptoms, and these effects often have a greater and longer-lasting impact than do major life events. iv. Many chronic stressors are linked to social relationships. Being outside the ingroup can be stressful. Being actively targeted by members of the ingroup can be even more stressful, especially if this happens repeatedly over time. v. Chronic stressors also can be linked to particular environments. The realization that chronic stressors are linked to environments has spawned the subfield of environmental psychology, the scientific study of environmental effects on behavior and health. d. Perceived Control Over Stressful Events

i. Stressors challenge you to do something—to take some action to eliminate or overcome the stressors. Paradoxically, events are most stressful when there is nothing to do—no way to deal with the challenge. ii. Expecting that you will have control over what happens to you is associated with effectiveness in dealing with stress. iii. The researchers David Glass and Jerome Singer, in classic studies of perceived control, looked at the aftereffects of loud noise on people who could or could not control it. iv. Studies have found that a lack of perceived control underlies other stressors, too. 2. Stress Reactions: All Shook Up a. Stress can produce changes in every system of the body and mind, stimulating both physical reactions and psychological reactions. b. Physical Reactions i. The fight-or-flight response is an emotional and physiological to an emergency that increases readiness for action. ii. Brain activation in response to threat occurs in the hypothalamus, initiating a cascade of bodily responses that include stimulation of the nearby pituitary gland, which in turn stimulates the adrenal glands atop the kidneys. iii. The pathway is sometimes called the HPA (hypothalamic-pituitaryadrenocortical) axis. iv. The adrenal glands release hormones, including catecholamines (epinephrine and norepinephrine), which increase sympathetic nervous system activation and decrease parasympathetic activation. v. The adrenal glands also release cortisol, a hormone that increases the concentration of glucose in the blood to make fuel available to the muscles. vi. General Adaptation Syndrome 1. In the 1930s, Canadian physician H. Selye subjected rats to heat, cold, infection, trauma, hemorrhage, and other prolonged stressors and found that the stressed-out rats developed physiological responses. 2. Noting that many different kinds of stressors caused similar patterns of physiological change, he called the reaction the general adaptation syndrome (GAS), which is defined as a three-stage physiological stress response that appears, regardless of the hallstressor that is encountered. a. Alarm Phase: equivalent to the fight-or-flight- response, in which the body rapidly mobilizes its resources to respond to the threat. b. Resistance Phase: the body tries to adapt and cope with the stressor by shutting down unnecessary processes.

c. Exhaustion Phase: the body’s resistance collapses, creating damage. vii. Stress Negatively Affect Health and Speeds Aging 1. As people age, the body slowly begins to break down. Interestingly, research has revealed that stress significantly accelerates the aging process. 2. Generally, people exposed to chronic stress, whether due to their relationships or jobs, or something else, experience actual wear and tear on their bodies and accelerated aging. 3. Understanding this process requires knowing a little bit about how aging occurs. 4. The cells in our bodies are constantly dividing, and as part of this process, our chromosomes are repeatedly copied so that our genetic information is carried into the new cells. Each time a cell divides, the tips of the chromosomes (called telomeres) become slightly shorter. 5. Over time, if the telomeres become too short, cells can no longer divide properly. 6. The recent discovery of the function of telomeres, and their relation to aging and disease, has been one of the most exciting advances in science in the past several decades. 7. Social stressors can play an important role in this process. 8. The good news is that activities such as exercise and meditation seem to prevent chronic stress from shortening telomere length, providing a potential explanation of how these activities may convey health benefits such as longer life and lower risk of disease. viii. Chronic Stress Affects the Immune Response 1. The immune system is a complex response system the protects the body from bacteria, viruses, and other foreign substances. The immune system is remarkably responsive to psychological influences. 2. Stressors can cause hormone known as glucocorticoids to flood the brain, wearing down the immune system and making it less able to fight invaders. 3. The effect of stress on immune response may help to explain why social status is related to health. 4. The stress of living life at the bottom levels of society may increase the risk of infection by weakening the immune system. ix. Stress Affects the Cardiovascular Health 1. The heart and circulatory system also are sensitive to stress. 2. Chronic stress also is a major contributor to coronary heart disease because prolonged stress-activated arousal to the sympathetic nervous system raises bp and gradually damages the blood vessels.

3. The damaged vessels accumulate plaque, in a process known as atherosclerosis, and the more plaque, the greater the likelihood of coronary heart disease. 4. During the 1950s, researchers conducted a revolutionary study that demonstrated a link between work-related stress and coronary heart disease. 5. Some men displayed a Type A behavior pattern, a tendency toward easily aroused hostility, impatience, a sense of time urgency, and competitive achievement strivings. Other men displayed a less driven behavior pattern (sometimes called Type B). 6. The Type A men were identified by their answers to questions in the interview, and also by the pushy and impatient way in which they answered the questions. c. Psychological Reactions i. The body’s response to stress is intertwined with responses of the mind. ii. Perhaps the first thing the mind does is try to sort things out—to interpret whether an event is threatening or not—and if it is, whether something can be done about it. iii. Stress Interpretation Is a Two-Step Process 1. The interpretation of a stimulus as stressful or not is called primary appraisal. 2. Primary appraisal allows you to realize that a small, dark spot on your shirt is a stressor (spider) or that a 70-mile-per-hour drop from a great high tina small car full of screaming people may not be (roller coaster). 3. The next step in interpretation is secondary appraisal, determining whether the stressor is something you can handle or not; that is, whether you have control over the event. 4. Interestingly, the body responds differently depending on whether the stressor is perceived as a threat (a stressor you believe you might not be able to overcome) or a challenge (a stressor you feel fairly confident you can control). 5. Although both threats and challenges raise the heart rate, threats increase vascular reactivity. 6. Fortunately, interpretations of stressors can change from threats to challenges. iv. Chronic Stress Can Lead to Burnout 1. When people feel that they have loss interest, especially about their jobs or careers, they are suffering from burnout, a state of physical, emotional, and mental exhaustion resulting from longterm involvement in an emotionally demanding situation and gas chroniaccompanied by lowered performance and motivation.

2. Burnout is a particular problem in the helping professions. People who repeatedly encounter emotional turmoil on the job may only be able to work productively for a limited time. 3. Eventually, many succumb to symptoms of burnout: overwhelming exhaustion, a deep cynicism and detachment from the job, and a sense of ineffectiveness and lack of accomplishment. 4. Their unhappiness can even spread to others. 5. But what causes burnout? a. One theory suggests that the culprit is using your job to give meaning to your life. If you define yourself only by your career and gauge your self-worth by success at work, you risk having nothing left when work fails. b. Others argue that some emotionally stressful jobs lead to burnout no matter how they are approached and that active efforts to overcome the stress before burnout occurs are important. 3. Stress Management: Dealing with It a. Mind Management i. Stressful events are magnified in the mind. If you do break down during a stressful event, intrusive memories of this stressful event could echo in your mind afterward. A significant part of stress managements, then, is control of the mind. ii. Repressive Coping: Holding an Artificially Positive Viewpoint 1. Controlling thoughts is not easy, but some people do seem to be able to banish unpleasant thoughts from the mind. 2. Repressive coping is characterized by avoiding feelings, thoughts, or situations that are reminders of a stressor and maintaining an artificially positive viewpoint. 3. It may make sense to try to avoid stressful thoughts and situations if you’re the kind of person who is good at putting unpleasant thoughts and emotions out of mind. For some people, however, the avoidance of unpleasant thoughts and situations is so difficult that it can turn into a grim preoccupation. 4. For those who can’t avoid negative emotions effectively, it may be better to come to grips with them. This is the basic idea of rational coping. iii. Rational Coping: Working to Overcome 1. Rational coping involves facing the stressor and working to overcome it. This strategy is the opposite of repressive coping, so it may seem to be the most unpleasant and unnerving thing one could do when faced with stress. 2. Rational coping is a three-step process:

a. Acceptance: coming to realize that the stressor exists and cannot be wished away. b. Exposure: attending the stressor, thinking about it, and even seeking it out. i. Psychological treatment may help during the exposure step by aiding victims in confronting and thinking about what happened; a technique called prolonged exposure. ii. This sounds like bitter medicine indeed, but it remarkably effective, producing significant reductions in anxiety and symptoms of PTSD w/ no therapy and compared with other therapies that promote more gradual forms of exposure. c. Understanding: working to find the meaning of the stressor in your life. 3. Reframing: Changing Your Thinking a. Changing the way, one thinks is another way to cope with stressful thoughts. b. Reframing involves finding a new or creative way to think about a stressor that reduces its threat. c. Reframing can take place spontaneously if people are given the opportunity to spend time thinking and writing about stressful events. In fact, engaging in such expressive writing was found to improve immune function, whereas suppressing emotional topics weakened it. d. The positive effect of self-disclosing writing may reflect its usefulness in reframing trauma and reducing stress. b. Body Management i. Stress often manifests itself through bodily symptoms, body management can reduce stress. Here are 4 techniques. 1. Meditation: Turning Inward a. Meditation is the practice of intentional contemplation. b. Techniques of meditations are associated with a variety of religious traditions and are also practiced outside religious context. At a minimum, all techniques have in common a period of silence. c. Time spent meditating can be restful and revitalizing Beyond these immediate benefits, many people also mediate in effort to experience deeper or transformed consciousness. Whatever the reason, meditation does appears to have positive psychological effects. Many believe it does so by improving control over attention.

d. Interestingly, experienced meditators show deactivation in the default mode network (which is associated with mind wandering) during meditation. Even short-term meditation training administered to college undergraduates has been shown to improve the connectivity between parts of the brain involved in conflict monitoring and cognitive and emotional control. e. Taken together, these findings suggest that meditators may be better able to regulate their thoughts and emotions, which may translate to a better ability to manage interpersonal relations, anxiety, and a range of other activities that require conscious effort. 2. Relaxation: Picturing Peace a. Our bodies respond to all things we think about doing every day. These thoughts create muscle tension even when we think we’re doing nothing at all. b. Relaxation therapy is a technique for reducing tension by consciously relaxing muscles of the body. A person in relaxation therapy may be asked to relax specific muscle groups one at a time or to imagine warmth flowing through the body or to think about a relaxing situation. c. This activity draws on a relaxation response, a condition of reduced muscle tension, cortical activity, heart rate, breathing rate, and blood pressure. d. Relaxing on a regular basis can reduce symptoms of stress and even reduce blood levels of cortisol. 3. Biofeedback: Enlisting the Help of an External Monitor a. Biofeedback, the use of an external monitoring device to obtain information about a bodily function and possibly gain control over that function, was developed with the goal of high-tech relaxation in mind. b. Biofeedback can help people control physiological functions they are not otherwise aware of. c. Often, however, the use of biofeedback to produce relaxation in the brain turns out to be a bi to of technological overkill and may not be much more effective than simply having the person stretch out in a hammock and hum a happy tune. 4. Aerobic Exercise: Boosting Mood a. Studies indicate that aerobic exercise (exercise that increases HR and oxygen intake for a sustained period) is associated with psychological well-being.

b. Researchers have suggested that the effects result from increases in the body’s production of neurotransmitters such as serotonin, which can have a positive effect on mood or from increases in the production of endorphins (the endogenous opioids). c. Perhaps the simplest thing you can do to improve your happiness and health, then, is to participate regularly in an aerobic activity. c. Situation Management i. Situation Management involves changing your life situation as a way of reducing the impact of stress on your mind and body. 1. Social Support: “Swimming with a Buddy” a. Other people can offer help in times of stress. Social support is aid gained through interacting with others. b. Good ongoing relationships with friends and family and participation in social activities and religious groups can be as healthy for one as exercising and avoiding smoking. Lonely people are more likely than are others to be stressed and depressed, and they can be more susceptible to illness because of lower-than-normal levels of immune functioning. c. Many first-year college students experience something of a crisis of social support. Newcomers typically find the task of developing satisfying new social relationships quite daunting. d. Time spent getting to know people in new social situations can be an investment in one’s own health. e. The value of social support in protecting against stress may be very different for women and men: i. Whereas women seek support under stress, men are less likely to do so. ii. The fight-or-flight response to stress may be largely a male reaction, whereas the female response to stress may instead be to tend-and-befriend by taking care of people and bringing them together. f. The tend-and-befriend response to stress may help to explain why women are healthier and have a longer life span than do men. The typical male response amplifies the unhealthy effects of stress, whereas the female response takes less of a toll on a woman’s mind and body and provides social support for the people around her as well. 2. Religious Experiences: Reaping Earthly Rewards

a. National polls indicate that over 90% of Americans believe in God and that most who do pray at least once per day. Although many who believe in a higher power believe that their faith will be rewarded in an afterlife, it turns out that there may be some benefits here on earth as well. b. An enormous body of research has found associations between religiosity (affiliation with or engagement in the practices of a particular religion) and spirituality (having a belief in and engagement with some higher power, not necessarily linked to any particular religion) and positive health outcomes, including lower rates of heart disease, decreases in chronic pain, and improved psychological health. c. Engagement in religious or spiritual practices, such as attendance at weekly religious services, may lead to the development of a stronger and more extensive social network, which has well-known health benefits. Those who are religious or spiritual also may fare better psychologically and physically as a result of following the healthy recommendations offered in many religious or spiritual teachings. 3. Humor: Laughing It Off a. Most of us recognize that humor can defuse unpleasant situations and reduce stress. b. There is a kernel of truth to the theory that humor can help us cope with stress. For example, humor can reduce sensitivity to pain and distress. In one study, participants wearing an overinflated blood pressure cuff were more tolerant of the pain during a laughter-inducing comedy audiotape than during a neutral tape or guided relaxation. c. Humor can also reduce the time needed to calm down after a stressful event. For example, men viewing a highly stressful film about three industrial accidents were asked to narrate the film aloud, either by describing the events seriously or by making their commentary as funny as possible. 4. Scheduling and Activating: Getting it Done a. Over 70% of college students report that they engage in some form of procrastination. Some procrastination defend this practice by claiming that they tend to work best under pressure or by noting that as long as a task gets done, it doesn’t matter if it is completed just before the deadline.

b. Although there is no proven method of eliminating procrastination, there is some evidence that procrastination i...