Stress and Coping Week 3 Notes
Stress and Coping Week 3 Notes PSYC 3199
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This 12 page Class Notes was uploaded by Freddi Marsillo on Friday September 16, 2016. The Class Notes belongs to PSYC 3199 at George Washington University taught by Howe in Fall 2016. Since its upload, it has received 6 views. For similar materials see Psychology of Stress and Coping in Psychology at George Washington University.
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Date Created: 09/16/16
Stress and Coping Week 3 Notes 9/16/16 4:09 PM How do we cope? Early ideas about coping • Problem-focused coping o Manage the stressor • Emotion-focused coping o Manage the associated emotions Some support for this framework: • Problem-focused coping led to better emotional response (such as less depression or anxiety) o In couples facing prostate cancer o In dementia caregivers • But not in people recently diagnosed with low grade brain tumors Problems with this framework • Emotion-focused coping was often associated with greater distress Emotion-focused coping associated with: • Suicidal ideation in: o Adult medical patients o Undergraduate women o Italian adolescents surviving a major earthquake • Greater anxiety or depression in: o Couples facing prostate cancer in men o First nation adults in Canada (mediated effects of childhood trauma) Evolving into more functional framework • Coping involves a range of actions (including thinking), both automatic and planned, that carry out one or more functions, including: o Changing or resolving stressful conditions o Altering the meaning of those conditions o Reducing discomfort • Coping may reflect: o More general styles that are consistent over time and place o More adaptive responses fitted to the current situation Changing the situation • Active, engaged problem solving is assumed to help resolve stressors o There is surprisingly little research on this • Brennan et al (2006) followed 1100 people from age 55 or so for 10 years o Periodically assessed stressors and whether they were resolved o More than 50% never or rarely resolved stressors o Predictors of later stressor resolution included: ▯ More directed than exploratory responses ▯ Less avoidance ▯ Less logical analysis But, are attempts to actively cope with the situation always positive? • Lin & Leung (2010): Reviewed research suggesting active job search associated with increased negative affect • Problem: contemporaneous correlation studies • Possibilities: o Job search generates more pressure, so job search ▯ depression o Depression increases motivation for job search, so depression ▯ job search o Both are shaped by a third factor, such as unemployment demands, so unemployment demands ▯ job search; depression Other situations where active control may be counterproductive • John Weisz (1994): studied children being treated for leukemia, who were exposed to: o Staying in the hospital overnight o Lumbar punctures o Bone marrow aspiration o Procedures leading to vomiting and hair loss Control versus adapting or giving up • Weisz asked children to describe goals, and what they did to cope with each of these 3 general responses: o To change environment o To adjust self (beliefs, hopes, goals, interpretations) to circumstances o To relinquish control (“there’s nothing I can do”) Serenity Prayer God grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference. Making new meaning – Secondary appraisal: Can I do something about it? Secondary appraisals that contribute to stress response Negative cognitive style (or negative attribution style) – Seligman & Abramson • Negative events are attributed to causes that are: o Stable (they can’t be changed) o Global (they are present across most of my life) o Internal (I am to blame for them) • Negative events are seen as: o Leading to more negative events in the future o Meaning that I am flawed in some way o Very important • Positive events are seen the opposite way: o Due to unstable, temporary causes o Unlikely to lead to more positive events in the future Negative Cognitive Style and Depression • Negative appraisals increase risk for depression in the face of negative life events • Fresco et al (2006) studied adults with prior history of depression or anxiety disorder • Attributions for both negative and positive events increased risk for depression over a one month period when faced with negative events Coping: Reappraisal Reappraisal: active cognitive process of altering secondary appraisals • Challenging negative efficacy expectations o Self-encouragement (“I think I can, I think I can”) o Clarifying what is doable • Maintaining positive expectations in the face of setbacks o Meichenbaum’s “inoculation against setbacks” o Job search is a series of “no’s” followed by a “yes” • Developing positive efficacy expectations o Oysermann’s “possible selves” interventions for inner city youth Effects of Reappraisals Brennan et al: resolution of stressors for older adults was predicted by: • More positive reappraisal of situations • Thinking of the stressor as a challenge rather than a threat Positive appraisal is associated with less depression in: • General populations • People exposed to violence and trauma in wartime 50 years earlier Meaning-making that alters goals • Park discusses several approaches to meaning-making that involve altering goals or their relative importance o Downward comparison: Thinking about others worse off than you ▯ For example, many cancer patients report thinking that they are a good deal better off than others who have had cancer o Putting things in perspective: Thinking about longer time frames or “the bigger picture” ▯ “Years from now, I won’t even remember this” Distancing as meaning-making Lin & Leung (2010) study of job loss Distancing: • Tell myself that time usually takes care of situations like this • Remind myself that other people have been in this situation and that I can probably do as well as they did • Remind myself that it isn’t the end of the world Results suggest that distancing does reduce negative emotions longitudinally Accepting • Accepting what comes, valuing the moment • Remember Weisz’s finding for children undergoing medical procedures o To adjust self (beliefs, hopes, goals, interpretation) to circumstances Reducing discomfort Coping: Self-Calming There are various methods for reducing autonomic arousal: • Progressive relaxation • Mindfulness meditation • Yoga • Physical exercise Seeking Social Support Seek comfort from others • Talking with a confidant • Foot rubs Pay Attention The Transactional Model – Part 3: Attention How do stressful circumstances shape our attention? Can we control attention in order to reduce stress? Is attention influenced by scarcity? • Scarcity as threat o Economic scarcity (poverty) o Friendship scarcity o Time scarcity • Scarcity as shaping attention and cognitive resources Attentional and cognitive impact of scarcity (Shah et al, 2012) • Scarcity appears to increase attention focus and engagement, but depletes those resources • Wheel of fortune study o Manipulation of scarcity: “guesses” available in word game o Followed by assessment of attention and cognitive control o Those in the initial “poor” condition scored worse, suggesting greater engagement and more subsequent fatigue • Scarcity can reduce cognitive capacity • Mall study (Mullainathan & Shafir, 2013) o Approached people in shopping malls and asked them to think about one of two scenarios: ▯ 1) Imagine that your car has some trouble, which requires a $300 service – your auto insurance will cover half the cost. You need to decide whether to go ahead and get the car fixed, or take a chance and hope that it lasts for a while longer. How would you go about making such a decision? Financially, would it be easy or a difficult decision for you to make? ▯ 2) Imagine that your car has some trouble, which requires an expensive $3,000 service… o Assessed self-reported income (split people half and half) Results of mall study • Administered Raven’s Matrices, a test of fluid intelligence • For those above the median for income, no differences due to manipulation • For those below the median, high-scarcity scenario led to drop of 14 points • Effect is larger than that in studies testing after people forced to stay awake all night • Suggests that scarcity primes attention and cognitive activity which reduces available resources for other things Scarcity and tunneling • “Tunneling”: Scarcity focuses us on immediate challenges, leading us to ignore longer-term consequences • “Present bias” leads to over-valuing immediate benefits at the expense of future ones • We end up borrowing resources, neglecting important but not urgent tasks • Appears true for various types of scarcity o Finances o Time Stressful Circumstance and Attention Extreme threat focuses us: • Most organisms orient toward danger cues What about less severe threat? • Can vary across contexts • More threatening contexts can increase attentional avoidance of danger cues in humans who do not avoid cues in less threatening contexts (Schechner et al, 2012) o Veterans exposed to trauma reminders o Soldiers undergoing simulated combat o Civilians exposed to rocket attacks Lab Studies of Attention • Dot-probe task used to evaluate effects of mild threat • Four steps: o Fixate o Briefly show word pair (one mildly threatening) o Show cue in same location as one word (either one or two stars) o Response: different key for each cue • Attentional avoidance if response is slower to cues associated with threat What happens in more threatening contexts? • Train people to associate presence or absence of shocks (“unpleasant but tolerable”) with background lights (green or orange) • Later conduct dot probe with lights (no shock) Results • Again, people are more likely to avoid attending to mild threat cues when general context is threatening Why? Could be adaptive” • In high threat situations, attending to mild threats is a waste of resources • In low threat situations, we have more leisure to attend to the minor things But… • Hypervigilance (heightened attention toward threat) is found in those with anxiety disorders o Patients with PTSD selectively attend to trauma-related words o Patients with social anxiety disorder respond most strongly to words of social judgment • Yet selective attention away from threat also found: o High trait anxious individuals avoid attention to threatening pictures o Maltreated children with PTSD show attentional avoidance or angry or threatening faces Vigilance Avoidance Hypothesis • Matthews (1990) • Attention bias follows time course o Elevated anxiety results in involuntary, automatic response to orient toward threat o Followed quickly by attentional avoidance • Suggests this is maladaptive because response can never habituate, perpetuating PTSD, anxiety • Evidence in lab studies o Orientation toward threat tends to be found early (100ms) o Avoidance tends to show a bit later (500-1500ms) Can we control attention in order to reduce stress? The White Bear Study Participant is told not to think of a white bear – this causes them to think of the white bear, no matter what ▯ Paradoxical effects of thought suppression – Daniel Wegner Freeing the white bear • Wegner recently reviewed research on strategies for thought suppression • Strategies and factors that make it worse: o Unfocused self-distraction o Mental load or stress Strategies that appear to help • Focused, self-distraction (“when a white bear comes to mind, think of a red car”) • Reducing demands or cognitive load • Writing about the thought: expression reduces intrusiveness • ACT: Acceptance reduces aversive nature of unwanted self thoughts Can we train people to use attention to reduce stress? Attention Bias Modification (ABM) • Problem: biased attention to negative stimuli • Possible protective mechanism: biased attention to positive stimuli • ABM: training to modify attention bias Study of Attention Bias Modification • Elaine Fox and colleagues (2011) • Stratified random assignment, based on genetic prescreening, to: o ABM for positive bias o ABM for negative bias Training shows impact, but that differs depending on serotonin transporter gene Meditation as attention training • Focused meditation (such as Transcendental Meditation) • Mindfulness meditation Training in Transcendental Meditation (TM) • Transcendental Meditation (TM) techniques (Charles Alexander) o 1970s-1980s o Focus on specific target (sound, image, sensation) o Continually return to that target as mind wanders o Methods for “calming the mind,” from Indian Vedic tradition o Programs involve training in meditation, establishing daily practice o Evidence for reduction in biological indexes of stress response o Much of the work here by proponents of TM, with few attempts to replicate in independent labs Training in Mindfulness Mindfulness Based Stress Reduction (MBSR: Jon Kabat-Zinn) • Borrowing from Buddhist Vipassana meditation tradition o Uses concentration forms of meditation as initial stage to develop stable base for awareness (often the breath) o Second stage: rather than suppressing awareness of anything but focus, emphasizes awareness of sensations, thoughts, feelings o New goal: an attitude of “friendly curiosity, interest, and acceptance toward all observed phenomena” o Emphasizes intention to refrain from evaluation and self- judgment, and to observe non-judgmentally when these occur MBSR Program Kabat-Zinn developed MBSR for patients with chronic pain and stress-related conditions • 8 week class, 2-3 hours per week, plus a one-day intensive session • Components involve: o Body scan: exercise to increase awareness of body sensations o Hatha yoga: also emphasizes awareness of sensation o Sitting meditation, practicing both concentration and awareness o Walking meditation MBSR Effectiveness Evidence from controlled trials • Williams et al (2001): trained university staff in MBSR o MBSR group reported reductions in daily hassles, distress, and medical symptoms as compared to controls • Davidson et al (2003) trained biotech company employees in MBSR o Using electroencephalography (EEG), found greater activation in left anterior brain, and less asymmetry between left and right activation (associated in other studies with positive emotions or reduced depression) o Found stronger antibody response to administration of flu vaccine Summary • Stressful circumstances can shape attention o Scarcity: focus and tunneling o Severity of threat • Attempts to suppress thoughts can make them worse • Expression/acceptance strategies seem to work better • Attention training methods (ABM, meditation) can be useful for stress reduction 9/16/16 4:09 PM 9/16/16 4:09 PM
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