Stress, coping, adjustment, and health |  |
Chapter OutlineStress, Coping, Adjustment, and Health
Models of the Personality-Illness Connection
- Interactional model
- Objective events happen to a person, but personality determines the impact of events by influencing a person's ability to copy
- Personality moderates the relation between stress and illness
- Coping response influences degree, duration, and the frequency of a stressful event
- Problem: Researchers are unable to identify stable coping responses that are consistently adaptive or maladaptive
- Transactional model
- Personality has three potential effects
- Can influence coping
- Can influence how a person appraises events
- Can influence events themselves
- Appraisal suggests that it is not the event itself that causes stress, but how the event is interpreted by a person
- People don't just respond to situations, they also create situations through choices and actions
- Health behavior model
- Personality does not directly influence the relation between stress and illness
- Instead, personality affects health indirectly, through health promoting or health degrading behaviors
- model
- Associations may exist between personality and illness because of a third variable that is causing them both
- Association found between illness and personality because of some predisposition that underlies them both
- Illness behavior model
- Personality influences the degree to which a person perceives and attends to bodily sensations, and the degree to which a person interprets and labels sensations as illness
- Most models of personality and illness include a key variable of stress
- Stress is not "out there" in our lives, representing something that happens to us
- Instead, stress lies in part in how we interpret and respond to those events
- Thus, stress lies "in between" the event and the person
The Concept of Stress
- Stress is a subjective feeling produced by events perceived as uncontrollable and threatening
- Stressors: Events that lead to stress and have several common attributes
- Extreme in some manner, in that stressors produce a state of feeling overwhelmed
- Produce opposing tendencies in us, such as wanting and not wanting some activity or object
- Perceive as uncontrollable
Stress Response
- Startle, heart beats fast, blood pressure increases, sweaty palms and soles of feet—fight-or-flight response, increase in sympathetic nervous system activity
- General Adaptation Syndrome (GAS)
- Alarm stage: Fight-or-flight response
- If stressor continues, stage of resistance: Body uses resources at above average rate, even though fight-or-flight response subsided
- Stress is being resisted, but takes a lot of person's energy
- If stressor is constant, the person enters the stage of exhaustion: More susceptible to illness, because physiological resources are depleted
Major Life Events (Holmes & Rahe, 1967)
- Identified both positive and negative events that are stressors
- People who experienced most stress also are more likely to have a serious illness over the next year
- Subsequent experimental work suggests that people under chronic stress deplete bodily resources and become vulnerable to infections
- Current thinking is that stress lowers the functioning of immune system, leading to lowered immunity to infection and resulting in illness
Daily Hassles
- Major events stress, but infrequent
- Daily hassles provide most stress in most people's lives
- Research indicates that people with a lot of minor stress suffer more from psychological and physical symptoms
Primary and Secondary Appraisal
- Stress is the subjective reaction of a person to potential stressors
- According to Lazarus (1991), in order for stress to be evoked, two cognitive events must occur
- Primary appraisal: Person perceives an event as a threat to goals
- Secondary appraisal: Person concludes they do not have resources to cope with demands of threatening event
A Closer Look: The Role of Positive Emotions in Coping with Stress
- General hypothesis: Positive emotions and appraisals may lead to a lowered impact of stress on health
- Three coping mechanisms are capable of generating positive emotion during stress (Folkman & Moskowitz, 2000)
- Positive reappraisal: Person focuses on the good in what is happening
- Problem-focused coping: Thoughts and behaviors that manage or solve an underlying cause of stress
- Creating positive events: Creating positive time-out from stress
Coping Strategies and Styles
Attributional Style
- Answer to question, "Where does the person typically place the blame when things go wrong?"
- Three dimensions of attribution: External versus internal, unstable versus stable, specific versus global
- Different measures: Attributional Style Questionnaire, Content Analysis of Verbatim Explanations (CAVE)
Refinements to the Attributional Style Construct
- Optimism-pessimism (Peterson, 2000): People who make stable, global, and internal explanations for bad events termed "pessimists," whereas people who make unstable, specific, external explanations for bad events termed "optimists"
- Dispositional optimism (Scheier & Carver, 2000): Expectation that good events will be plentiful and bad events rare in future
- Self-efficacy (Bandura, 1986): Belief that one can do behaviors necessary to achieve desired outcome
- Optimistic bias: People generally underestimate their risks, with the average person rating risks as below true average
Optimism and Physical Well-Being
- Optimism predicts good health and health promoting behaviors
A Closer Look: How Does Optimism Promote Health?
- Through the effects on the immune system
- Through an emotional mechanism
- Through a cognitive process
- Through effects on social contacts
- Through direct behavioral mechanism
Management of Emotions
- Some theorists suggest that emotional inhibition leads to undesirable consequences
- Other theorists see emotional inhibition more positively
- Chronically inhibited emotion seems to come with certain "costs" to the nervous system
- Someone who characteristically inhibits emotional expression may suffer effects of chronic sympathetic nervous system arousal
- Also, emotions serve the function of communicating to others how we are feeling
- Research indicates that emotional expressiveness may be good for our psychological health and general adjustment
Disclosure
- Pennebaker argues that not discussing traumatic, negative, upsetting event can lead to problems
- Telling a secret can relieve stress, increase health
Type A Behavior and Cardiovascular Disease
- Type A behavior pattern
- Achievement motivation and competitiveness
- Time urgency
- Hostility and aggressiveness
- Early studies of Type A found it was an independent risk factor for developing cardiovascular disease
- Early studies conducted by physicians using structured interview
- Later research used self-report surveys
- Studies using surveys less likely to find relationships between Type A and heart disease than studies using structured interview
- Structured interview gets at the lethal component
Hostility: The Lethal Component of the Type A Behavior Pattern
How Are the Arteries Damaged by Hostile Type A Behavior?
Summary and Evaluation
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2002 McGraw-Hill Higher Education