Coping with stress
Coping with stress Psyx 383
Popular in Health Psychology
Popular in Psychology
This 14 page Class Notes was uploaded by Lindsay Bellinger on Monday October 10, 2016. The Class Notes belongs to Psyx 383 at University of Montana taught by Mark Primosch in Fall 2016. Since its upload, it has received 4 views. For similar materials see Health Psychology in Psychology at University of Montana.
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Date Created: 10/10/16
Health Psychology Chapter 5 – Coping with stress Responding to stress Coping: The cognitive, behavioral, and emotional ways in which we manage stressful situations and includes any attempt to preserve physical and mental health Coping is a dynamic process, it is a series of responses involving our interactions with the environment Approach coping and avoidant coping Approach (vigilant) coping - A coping strategy that directly confronts the stressor and attempts to develop a solution by gathering information and taking direction Avoidant (minimizing) coping - A strategy for coping with stressors by withdrawing from them and avoiding them o Passive behaviors o Antisocial behaviors Problem focused and emotion focused coping Problem focused coping - A coping strategy for dealing directly with a stressor, in which we either reduce the stressors demands or increase our resources or meeting its demands Emotion focused coping - A coping strategy in which we try to control our emotional response to a stressor - We tend to use this when we believe there is little or nothing that can be done to alter a stressful situation or when we realize our coping skills are insufficient Meta-analysis studies have found that problem-focused strategies are more often linked to better health outcomes than emotion-focused coping Which strategy works best is dependent on whether the stressor is controllable One type of emotion based coping has been linked too emotional distress and a variety of health issues - Rumination: thinking repetitively about an upsetting situation and how it relates to past and future problems associated with a stressor - Emotional cascade: occurs when rumination is not kept under control, resulting in an intense, painful state of negative emotion o May lead to self-harming behaviors, or self-medicating with excessive amounts of drugs or alcohol Emotional approach coping Comprised of two emotion-regulating processes - Emotional processing - Emotional expression Involves working through, clarifying and understanding the emotions triggered by a stressor through the use of behavioral strategies (keeping ourself busy) or cognitive strategies (denying unpleasant information) Coping; gender, genes and socioeconomic status Gender Men and women exhibit a number of different physiological reactions to stress depending on the nature of the stressor When experiencing acute laboratory stressors, women exhibit lower blood pressure reactivity than men Men display greater secretions of catecholamine’s when stressed Women display stronger glucocorticoid response when stressed Emotional approach coping in not unequivocally effective for men, particularly for those who display higher levels of masculinity and gender role conflict - Many men curb their emotions as a result of being socialized into a restrictive norm of masculinity Men are more likely to use problem-focused coping strategies in dealing with stress, and women are more likely to use emotion-focused coping strategies Gender differences in coping with stress 1. The socialization hypothesis: because of traditional stereotypes, women and men are brought up to cope with stress in different ways o Men are encouraged to take action and remain strong o Women are socialized to seek social support and express their emotions 2. Role constraint hypothesis: when stressors are the same for men and women, gender is irrelevant in predicting coping reactions o Men and women have different social roles, which in turn make them more likely to experience different types of stressors (differences in coping are therefore due to differences in stressors) Genes Genetic makeup can moderate how people respond to catastrophic events and other stressors Researchers examined 755 adults whose homes were damaged during the Chi-Chi earthquake in Taiwan in 1999 - Peoples whose homes were damaged felt less control over their lives and rated their health as poorer than those who were not affected by the earthquake These outcomes were found only to occur among people who were carriers of a particular allele of the apolipoprotein E gene (APOE) - Suggests that when people experience a traumatizing event, those who carry risk mutations in their genotype may be more susceptible to bad health outcomes Socioeconomic status People who have more resources available typically cope with stressors better People with low socioeconomic status typically have increased risk for chronic disease, disability and premature morality Stressful experiences are especially common among many ethnic minority families, who tend to be overrepresented in groups of low socioeconomic status Children with highly reactive emotional styles who grow up in low socioeconomic environments had higher levels of chronic inflammation than children with highly reactive emotional styles who grew up in higher socioeconomic status families - Chronic inflammation is associated with hypertension, heart disease and diabetes Regardless of ethnicity, people with low socioeconomic status tend to rely less on problem focused coping than people with higher education and higher incomes - Their demeaning social experiences may cause them to develop a feeling of hopelessness and to believe they have little psychological control over events in their lives, so wit repeated stress and no way out; their only option is to try and control their emotional responses to stress Socioeconomic status is inversely related, among both African-American women and men, to alcohol consumption, cigarette smoking and risk of hypertension Social cohesion: trust and solidarity between neighbors Social control: confidence that neighbors would maintain the neighborhood well-being Neighborhood problems: communitywide stressors such as litter or traffic noise Neighborhood vigilance: threat and vulnerability within the neighborhood Coping and ethnicity Three factors explaining interactions between socioeconomic status, gender and ethnicity 1. Middle-class African American men report higher levels of racial discrimination than African American women – perceived discrimination is a significant stressor that can affect physical and mental health 2. The attainment of middle-class status may be tenuous and marginal for some African-Americans o E.g. African-American college graduates are more likely to experience unemployment and job insecurity which results in higher stress levels 3. African-American males may experience a unique source of stress because their educational achievements often do not correlate with their income salaries in comparison to other men – this results in excess stressors John Henryism: A pattern of prolonged, high-effort coping with psychological demands and stressors, including barriers to upward social mobility African-Americans who score highly on the JH scale for active coping engage in high-effort coping with psychosocial demands and stressors, including career issues, health problems and racism The JH pattern of coping behaviors may help explain why they develop high blood pressure more often, and at an earlier age Factors affecting ability to cope with stress Hardiness: - A cluster of stress-buffering traits consisting of: o commitment o challenges vs threats o control - Hardy people view everyday demands of life as challenges rather than threats - They are also committed to their families, jobs, communities, and other groups that give their life meaning - They have a sense of control over their lives - Tend to be healthier because they are less likely to become aroused by stressful situations Research has found personal hardiness to be an effective indicator of successful adjustment to numerous health problems, including cancer, cardiovascular disease, diabetes and hypertension. Hardiness has also been linked to lower levels of anxiety, active coping styles and reduced vulnerability to depression Evaluating the hardiness hypothesis Some researchers have found that the hardiness-health relationship is more applicable to men than to women (more men in the study than women) It has also been suggested that hardy people are healthier due to having greater personal resources (income, education, social support, and coping skills) and often tend to be younger than the less hardy Research studies seem to demonstrate that some people handle stress more effectively because they view themselves as choosing to live the challenging lives – these individuals often view stressful events more positively (seeing them as benefiting their lives) Resilience The quality of some children to bounce back from environmental stressors that might otherwise disrupt their development and the ability to adapt flexibly to changing environments The case of Jacqueline: - Was abused as a child, went through the death of her foster mother, was placed in various homes and orphanages, and had an unstable childhood - Psychology would suggest that this would lead her into being an anti- social and problem ridden, however this did not happen (due to her resilience) Where does resilience come from? 1. Individual traits o Temperament, high self-esteem, strong personal control, self- discipline 2. Positive life experiences and social support o Social support Resilient children have well developed social, academic or create skills; easy temperaments, high self-esteem, self-discipline and strong feelings of personal control. These elements of social cognition foster healthy relationships with others who help children to adjust to adverse situations Studies of resilient children highlight the importance of at least one supportive person in the child’s life (aunt, uncle, sibling) – this supportive person is a model of resilience who plays a significant role in convincing at- risk children that they will be ok Biological resilience: various protective factors (genetic, demographic, socio-cultural, psychological) contribute to various protective factors in the elderly Explanatory Style Explanatory style - Our general propensity to attribute outcomes always to positive causes or always to negative causes (e.g. personality, luck or someone else’s actions) People who have positive explanatory style and are optimistic tend to cope better with stress than those with a negative explanatory style Pessimism (negative explanatory style): When something bad happens, these people often internalize the went and think it was their fault, they globalize the problem Optimism (positive explanatory style): When something bad happens, they see the positive outcomes of that event and see the benefits of it, externalize the negative events and understand it won’t last forever – learned optimism Personal control and choice Personal control: the belief that we make our own decisions and determine what we do and what others do to us (Bandura) Self-efficacy: belief in our ability to deal with stressful situations and make changes in our environment – what we do WILL lead to a change (Seligman) Learned helplessness: when people repeatedly fail at something, they feel helpless (give up) and therefore their anxiety and stress levels are increased Personal control and coping strategies In contrast to those with learned helplessness, people with a strong sense of personal control tend to engage in adaptive, problem-focused coping. Increased levels of stress have been found to coincide with increases in emotion focused coping Those who feel a strong sense of psychological control are more likely to exercise direct control over health-related behaviors Feeling in control of aversive life events plays a crucial role in determining our response to stressful situations Regulatory Control Regulatory control: the various ways in which we modulate our thinking, emotions, and behavior over time and across changing circumstances Controlling your responses and emotions has broad implications for your health Self-regulation is associated with success in dieting, quitting smoking and maintaining good interpersonal relationships Children who have good self-control are calmer, more resistant to frustration, better able to delay gratification and less aggressive Under controlled people are more likely to become aggressive and experience depression as they dwell obsessively on self-defeating thoughts Individual differences in regulatory control are related to how people cope with stressful events and situations People with good self-control are less likely to resort to maladaptive coping resources such as angry venting of emotions or avoidant coping Cardiovascular reactivity Physiologically, our reactivity to psychological stress seems to be quite stable Situations that are appraised as threatening are associated with a different pattern of cardiovascular reactivity than situations seen as challenging Cardiovascular reactivity: changes in the cardiovascular system activity that are related to psychological stress Threatening situations have been linked with enhanced vascular responses, as reflected by increases in diastolic blood pressure and total peripheral resistance Challenging situations have been linked with increased myocardial activity; reflected by increases in heart rate and cardiac output Most changes in heart rate (due to stress) are controlled by the tenth cranial nerve, which is the longest in the body The vagus nerve plays an important role in the parasympathetic nervous system’s calming response; its main function is to lower blood pressure and heartrate Cardiovascular reactivity is a biological marker of individual differences in regularity control during moments of stress People with high vagal tone experience less negative emotional arousal in response to stress Choice, culture and control Situations in which there is no choice or in which choice has been removed have been linked to detrimental effects of motivation performance and health However, too much choice (in the workplace) may be detrimental to motivation and well-being Individualistic cultures: perceiving oneself as having less choice = negative effects European-Americans: strong sense of freedom and choice showed lower levels of depression and anxiety than those who perceived less choice and freedom - This was not the case for Asian-Americans and Asians Hispanic-Americans also demonstrated the negative association between these perceptions and distress, even after variables such as socioeconomic status were taken into account Repression and Negative effectivity Repressive coping: An emotion-focused coping style in which we attempt to inhibit our emotional responses, especially in social situations so we can view ourselves as imperturbable – we hide that we are stressed and try to act normally Negative affectivity: A coping style or personality dimension consisting of chronic negative emotions and distress (also known as neuroticism) Is repression healthy? - Emotional suppression activates the sympathetic division of the autonomic nervous system, functioning like a stressor in elevating blood pressure and triggering the fight or flight response - Inhibited emotional expression has also been shown to contribute to greater cortisol activity in people with cardiovascular disease Repressive coping has been associated with the development of cancer, asthma and diabetes – repressors are more cancer-prone than non- repressors There is a strong relationship among repression, avoidance coping and various types of negative effect (including pessimism, depression, and generalized anxiety) Social Support Social support: companionship from others that conveys emotional concern, material assistance, or honest feedback about a situation In stressful situations, people who receive a high level of social support may experience less stress and may cope more effectively with stress Evidence 1. Faster recovery and few medical complications 2. Lower mortality rates 3. Less distress in the face of terminal illness How does social support influence health? Buffering hypothesis: social support produces its stress-busting effects indirectly by helping the individual cope more effectively Direct effect hypothesis: Social support produces its beneficial effects during both stressful and non-stressful times by enhancing the body’s physical responses to challenging situations Who receives social support? People who relate well to others and who are caring and giving generally have stronger social networks, and so in times of need they have more people to turn to for help Angry and hostile people have weaker and smaller social networks and so do not receive as much social support College hostility predicts low social support, risk for depression, achieving less than expected in careers, poor relationships and excessive alcohol consumption When social support is not helpful Although support may be offered, a person may not perceive this as beneficial – the person may not want support, may think the support is inadequate or may not notice the support has been offered - E.g. In the first hours of losing a loved one, individuals often want to spend time on their own with nobody around them to cope with their grief alone The type of support offered may not be appropriate to what is needed – people may need physical help with taking care of chores as oppose to emotional stability help Too much social support may actually increase a person’s stress – being a member of too many social organizations can provide social support but can also be extremely stressful Gratitude Humor Pets Spirituality Spiritual activity may promote health by fostering more positive emotions, including an optimistic and hopeful world view, feelings of acceptance and personal control and a sense that life is meaningful Invisible support: the perception that people in the community care and are standing by to provide assistance if needed Personality and coping: Extraversion: happiness, high energy, competence, assertiveness, confidence Neuroticism: distress, anxiety, negative emotion, easily upset Conscientiousness: organized, purposeful, persistent, plan things, Agreeableness: helpful, friendly, empathic Openness to Experience: intellectual, flexibility, curiosity, creativity, exploration Coping Interventions Stress management: The various psychological methods designed to reduce the impact of potentially stressful experiences Biofeedback: treatment technique in which people are trained to improve their health by using signals from their own bodies Three phases of facing challenges: 1. Education o Learn what stress is and how it affects health 2. Acquiring skills o Trained to monitor stress in their everyday lives 3. Practicing skills o Applying new skills to monitor and reduce stress in healthy ways Relaxation Therapies Progressive muscle relaxation: A form of relaxation training that reduces muscle tension through a series of tensing and relaxing exercises involving the bodies major muscle groups Relaxation response: A meditative state of relaxation in which metabolism slows and blood pressure lowers Relaxation training can help patients cope with a variety of stress-related problems such as hypertension, headaches, depression, lower back pain and anxiety Underlying the effectiveness of these techniques is their ability to reduce heart rate, muscle tension and blood pressure Mindfulness Mindfulness-based stress reduction: A form of therapy that focuses on using structured meditation to promote mindfulness, a moment-to-moment non-judgmental awareness - Used to improve people’s ability to self-regulate negative reactions to stress Cognitive behavioral therapy: The use of principles from learning theory to change unhealthy patterns of thinking and behavior - Based on the view that our way of thinking about our environment, rather than the environment itself, determines our stress level Cognitive Behavioral Stress Management Combines relaxation training, visualization, cognitive restructuring and reinforcement Begins with teaching people to confront stressful events with a variety of coping strategies that they have been taught Stress inoculation training: a three stage process, with the therapist using a weakened dose of the stressor in an attempt to build immunity against the full-blow stressor 1. Reconceptualization 2. Skills acquisition 3. Follow-through It has been proven to be effective in helping people cope with variety of stress-related problems; job stress, hypertension, PTSD, depression Expressive writing Pennebaker - students were asked to write in their journal either trivial problems or deep issues that they were having - it was found that those who wrote deep stressful situations in their journal visited the university health center far less often Alexithymia: the inability to identify and describe your own emotions - Linked to increased cardiovascular mortality Writing or talking about stressful events may help lower the risk of cardiovascular disease Confiding in others may allow us to gain helpful insight and advice and may also provide social support
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