Week Four Assignment Transactional Model of Stress and Coping
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TheoryofStressCopingandHealthBehavior2.pptxTheory of Stress, Coping and Health Behavior
Stress
Subjective feeling produced by events that are uncontrollable or threatening
Stress is "the non-specific response of the body to any demand". Hans Selye, MD
Eustress
Eustress can be defined as a pleasant or curative stress. We can't always avoid stress, in fact, sometimes we don't want to. Often, it is controlled stress that gives us our competitive edge in performance related activities like athletics, giving a speech, or acting
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Distress
Distress is an unpleasant or disease-producing stress. Chronic, sustained, uncontrolled stress of a negative type may lead to a compromised immune system, illness, and even death. As a result, we all should become more aware of common or persistent distressors in our lives and initiate methods for managing them.
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Stressors
Demands made by the internal or external environment that upset the individual’s homeostasis, thus affecting their physical and psychological well-being and requiring action to restore that balance or equilibrium
Stressors – events that cause stress
Catastrophes
Major life events – good and bad!
Daily Hassles
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Cannon (1932)
Described fight-or-flight reaction
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Fight-or-Flight Response and how it is different with regards to anxiety disorders. This is my attempt to explain the difference between “normal people” (God, I really hate having to use that term) and those who suffer from anxiety and panic disorders. I am a member of the latter group. The Fight-or-Flight Response is a biological and psychological change that occurs in the body when a danger is perceived. In anxiety and panic disorders, the brain is acting as if there is a threat or danger even if there is not, in reality, one present at all. The following should explain why we sufferers cannot just “snap out of it” and remain in our excited, agitated and nervous state. Let's start by taking an example. If you are hiking through the woods and suddenly come upon a wolf, your body and mind stop for a split second and the body begins pumping chemicals through your system and preps your body for the decision that is being made in that split-second, do you fight the wolf or run like a bat out of hell? This split-second decision is usually made while our bodies are "paralized by fear", or standing perfectly still, another instinctive reaction left over from years of evolution. Your brain becomes highly alert, and your heart starts pumping furiously and your breathing changes. The following list of what happens physiologically is taken from the book “Principals of Anatomy and Physiology,” by Tortura and Grabowski, eighth edition. Stress excites the sympathetic nervous system, the hypothalamus, pituitary gland, and adrenal cortex. This produces the following effects:
The pupils of the eyes dilate.
Heart rate and force of contraction and blood pressure increase.
The blood vessels of nonessential organs such as the kidneys and gastrointestinal tract constrict.
Blood vessels of organs involved in exercise or fighting off danger – skeletal muscles, cardiac muscle, liver, and adipose tissue – dilate to allow faster flow of blood. (The liver splits glycogen to glucose and adipose tissue splits triglycerides to fatty acids, both of which are used by muscle fiber to generate ATP.)
The rate and depth of breathing increase and the airways dilate, which allow faster movement of air in and out of the lungs.
Blood glucose level rises as liver glycogen is converted to glucose.
The medullae of the adrenal glands are stimulated to release epinephrine (adrenaline) and norepinephrine (noradrenaline). These hormones intensify and prolong the sympathetic effects just described.
Processes that are not essential for meeting the stress situation are inhibited. For example, muscular movements of the gastrointestinal tract and digestive secretions slow down or even stop.
In today's society, in which we aren't threatened by wild beasts very often, most people will have a fight or flight response to things like taking a test. To paraphrase from the book, if the stress remains for a long period of time, the excitation becomes more prominent and if it remains for weeks or months it can weaken the immune system. In this state, there may be a reduction of the levels of epinephrine and norepinephrine (also called adrenaline and noradrenaline) in the brain, which are two neurotransmitters that many medications given to people with anxiety and panic disorders try to alter.
The following image is taken from an article from Discover Magazine that was published on their website at http://www.discover.com/mar_03/gthere.html?article=gthere.html?article=featfear.html Basically what this means is that your brain is changing the way it communicates with itself to deal with a perceived threat. Sufferers from an anxiety or panic disorder may have their brain “stuck” in this “on” position.
I'm going to add a few quotes from a great book by Dr.Robert M. Sapolsky called Why Zebras Don't Get Ulcers. This book focuses on the stress response and chronic stress, which is basically what the Fight-Or-Flight response or an Anxiety disorder is.
During stress, sexual drive decreases in both sexes; females are less likely toovulate or carry pregnancies to term, while males begin to have trouble with erections and secrete less testosterone. This explains why people with anxiety disorders have difficult sex lives.
During the Fight-Or-Flight response, less saliva is produced, which helps explain why people with anxiety disorders suffer from dry mouth and dental problems.
...the longer the stressor lasts, the longer the cumulative time of exposure to CRF, causing inhibition of appetite. CRF is Corticotropin Releasing Factor, a hormone secreted by the hypothalamus in the brain. This explains the poor eating habits of people with anxiety disorders, and why I often eat only one meal a day.
Another, ah, interesting facet of prolonged periods of the Fight-Or-Flight response is diarrhea and other bowel disorders.
But why, to add insult to injury, is it so frequently diarrhea when you are truly frightened? Relatively large amounts of water are needed for digestion, to keep your food in solution as you break it down so that it will be easy to absorb into the circulation when digestion is done. The job of the large intestine is to get that water back, and that's why your bowels have to be so long-the leftovers slowly inch their way through the large intestine, starting as a soupy gruel and ending up, ideally, as reasonably dry stool. Disaster strikes, run for your life, increase that large intestinal motility, and everything gets pushed thorugh too fast for the water to be absorbed optimally. Diarrhea, simple as that.
Irritable bowel syndrome (IBS) is a hodgepodge of disorders in which there is abdominal pain (particularly just after a meal) that is relieved by defecating and which, at least 25 percent of the time, includes symptoms such as diarrhea or constipation, passage of mucus, bloating and abdominal distention.
All this helps to explain why people such as me are sick most of the time - our bodies are stuck trying to fight off physical or more often psychological stressors that the body simply doesn't have the time or resources to combat diseases or digest food and get the proper nutrients to build new cells. I have to learn to live with the fight-or-flight response on a daily, on-going basis. Medications that alter brain chemistry (usually) help greatly manage this bodily response. Other ways I use to calm myself are to calmly tell myself there is no danger, I am safe and surrounded by safe people. Also, forcing myself to breath long, slow, deep breaths help. But the bottom line is there is a chemical imbalance that is stuck in the on position and all of the above methods are needed in order to just make it through the day without running away in fear or fighting in anger. I hope this helps you all understand what goes on behind both an acute panic attack and general anxiety disorders.
Stress and Gender
Perception of events as being stressful tends to differ between the gender
Emotional response to stress may also differ
Coping strategies have been observed as different
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Are the difference due to nature or nurture?
Differences more of a qualitative issue than being totally different
A pimple
"tend-and-befriend"
The model, called "tend-and-befriend" by its developers, won't replace fight-or-flight. Rather, it adds another dimension to the stress-response arsenal, says University of California, Los Angeles, psychologist Shelley Taylor, PhD, who, along with five colleagues, developed the model.
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females respond to stressful situations
In particular, they propose that females respond to stressful situations by protecting themselves and their young through nurturing behaviors--the "tend" part of the model--and forming alliances with a larger social group, particularly among women--the "befriend" part of the model. Males, in contrast, show less of a tendency toward tending and befriending, sticking more to the fight-or-flight response, they suggest.
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Evolutionary explanation- men need to fight the lion, women need to throw themselves on top of their baby to save it.
huge gap in the stress response literature
The tend-and-befriend model fills what Taylor sees as a huge gap in the stress response literature: namely, that almost all the studies have been conducted in males and so, therefore, upheld fight-or-flight as the main response to stress.
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the way females respond to stress
The tend-and-befriend response, in contrast, fits better the way females respond to stress. It builds on the brain's attachment/caregiving system, which counteracts the metabolic activity associated with the traditional fight-or-flight stress response--increased heart rate, blood pressure and cortisol levels--and leads to nurturing and affiliative behavior.
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fight-or-flight less likely in females.
From research into the neuroendocrine responses responsible for fight-or-flight, for example, they document that, although women do show the same immediate hormonal and sympathetic nervous system response to acute stress, other factors intervene to make fight-or-flight less likely in females.
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female aggression appears to be more cerebral in nature
In terms of the fight response, while male aggression appears to be regulated by androgen hormones, such as testosterone, and linked to sympathetic reactivity and hostility, female aggression isn't. Instead, female aggression appears to be more cerebral in nature--moderated by social circumstances, learning, culture and the situation--and in animals "confined to situations requiring defense," write the researchers.
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Men- more nature
Women-more nurture
the hormone oxytocin
In terms of flight, fleeing too readily at any sign of danger would put a female's offspring at risk, a response that might reduce her reproductive success in evolutionary terms. Consistent with this idea, studies in rats suggest there may be a physiological response to stress that inhibits flight. This response is the release of the hormone oxytocin, which enhances relaxation, reduces fearfulness and decreases the stress responses typical to the fight-or-flight response.
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Labor
Breastfeeding
Orgasm
bonding
important behaviors like affiliation
Adds Taylor: Mainstream stress researchers "have been very quick to study behaviors like aggression and withdrawal and have failed to notice very important behaviors like affiliation. We think it's cute when women call up their sisters when they're under stress. But no one has realized that that is a contemporaneous manifestation of one of the oldest biological systems. Our focus on fight-or-flight has kept us from recognizing that there are systems that are as old as fight-or-flight that are tremendously important."
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This Photo by Unknown Author is licensed under CC BY-NC-SA
Experimental approach to question: Is stress related to susceptibility to illness?
Cohen, Tyrrell & Smith (1997)
Obtained reports of stressful
life events according
to Holmes & Rahe’s criteria
Received nose drops with or without cold virus
What happened?
Participants w/more stress got more colds!
Consistent w/GAS
Transactional Theory of Stress and Coping
In this model, stressful experiences are construed as person-environment transactions wherein the impact of an external stressor, or demand, is mediated by the person’s appraisal of the stressor and the psychological, social, and cultural resources at his disposal
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STRESSOR
PRIMARY APPRAISAL
Relevant to you?
Relevant but not threatening
Stressful...relevant AND threatening
SECONDARY APPRAISAL
The evaluation of personal resources to cope with the threat...
“Can I deal...?”
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Stressors
When faced with a stressor, a person evaluates the potential harm or threat (primary appraisal), as well as his ability to alter the situation and manage negative emotional reactions (secondary appraisal)
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Tiger or kitty?
Coping strategies
Emotion-focused coping
characterized by the conscious regulation of emotion in which people seek to change the way they feel or perceive the problem
Problem-focused coping
attempts to change the stressful problem or source of the stress
Emotion-Focused
some people tend to ‘awfulize’ everything
The words we use to giving meaning to our stressors can affect our appraisals
This Photo by Unknown Author is licensed under CC BY-SA
Coping Efforts
Actual coping efforts, aimed at
problem management (strategies directed at changing a stressful situation)
emotional regulation (strategies aimed at changing the way one thinks or feels about a stressful situation)
give rise to the outcomes of the coping process (adaptation) (Lazarus & Folkman, 1984)
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Primary Appraisal
Primary appraisal is a person’s judgment about the significance of an event as stressful, positive, controllable, challenging, benign, or irrelevant
Two basic primary appraisals are perceptions of susceptibility to the threat and perceptions of the severity of the threat
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Observe the similarities with the Health Belief model
My boyfriend or girlfriend left me. Its over. No, I am better off without him
The condom broke
Primary Appraisal
Appraisal of personal risk and threat severity prompt efforts to cope (problem focused, emotion focused) with the stressor
However, heightened perceptions of risk can also generate distress. Appraisals of high threat can also prompt escape/avoidance behaviors
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Primary Appraisal
Primary appraisals can also serve to minimize the significance of the threat, particularly when the health threat is ambiguous or uncertain
Other primary appraisals involve motivational relevance and causal focus of the stressor
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The condom broke, am I going to get pregnant? Am I going to get an STI?
Whose fault is it?
Primary Appraisal
When a stressor is appraised as having a major impact on a person’s goals or concerns, that person is likely to experience anxiety
Perceiving oneself as responsible for the stressor can generate guilt and depression
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If I am pregnant, my life will be ruined. I won’t be able to finish school.
It is my fault I should have been using something beside the condom. I am such an idiot.
Secondary Appraisal
Secondary appraisal is an assessment of the person’s coping resources and options; it addresses what one can do about the situation
Key examples are the perceived ability to change the situation, perceived ability to manage one’s emotional reactions to the threat, and expectations about the effectiveness of one’s coping resources
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I can handle the emotional pain of the break up.
The morning after pill.
It is not the end of the world
Perceived Control
Perceived control may improve physical well-being by increasing the possibility that the person will adopt recommended health behaviors
However, beliefs about personal control are likely to be adaptive only to the extent that they fit with reality
Self-efficacy is specific for a given behavior
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I will use contraception that is effective.
Only God can determine if I get pregnant of not,or if I get and STI.
I know I am good about taking a pill everyday.
I can’t lose weight
Coping Efforts
problem management strategies are directed at changing the situation; more adaptive when the stressor is changeable
emotion focused efforts aim to change the way one thinks or feels about it; more adaptive when the stressor is not changeable
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The serenity prayer
Coping Strategies
Problem Management
Emotional Regulation
Active Coping
Problem solving
Information Seeking
Social support
Venting
**Feelings of
Avoidance and
denial
Most Adaptive to
problems
that are changeable
Directed at changing
the way one thinks
or feels about a
Stressful situation
**Generally considered maladaptive
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My father does not want to think about death or dying, or illness. Let the doctor handle it.
My sister wants to know every single detail
Other coping responses to health threats Meaning-based coping
Positive reinterpretation,
Acceptance
Religion and spirituality
Outcomes
The extent to which specific coping strategies result in desirable or undesirable outcomes may depend on whether short- or long-term goals are considered to be more important
Coping flexibility has been found to be important in health promotion
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What is more important? Having that dress or buying a house?
Adaptation
Coping outcomes represent individuals’ adaptations to the stressors, following from their appraisal of the situation and resources, and influenced by coping efforts
The main categories of outcomes are emotional well-being, functional status, and health behaviors
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Coping Styles
in contrast to coping efforts, coping styles are conceptualized as dispositional or stable characteristics of the individual
the former are situation-specific, while the latter are generalized
coping efforts can be considered mediators of the effects of stress and appraisals on emotional and functional outcomes
coping styles are enduring traits believed to drive appraisal and coping efforts
individual differences in coping styles can be considered moderators of the impact of stress on coping processes and outcomes
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Long lasting traits
Coping Styles-Optimism
the most widely researched coping style is dispositional optimism - the tendency to have positive generalized expectations for outcomes. Appears to exert effects on each of the key processes of the model
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Optimism
Seligman, a well-known researcher in the area of optimism, summarizes the essence of optimism:
“Changing the destructive things you say to yourself when you experience the setbacks that life deals us is the central skill of optimism.” (Seligman, 1991, p.15)
You will notice that being optimistic is not just being positive during the good times, but also being able to maintain positive thoughts about ourselves, even during life’s setbacks.
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Health Benefits of Optimism
better health habits
better immune functioning and fewer illnesses
less severe illnesses
fewer symptoms of poor health
faster recovery from illness and injury
better adjustment to serious illness
decreased psychological illness and distress
a tendency to live longer
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Buffers Against Stress
Social Support - emotional - appraisal - informational
Hardiness - commitment - challenge - Internal Locus
Optimism
Coping with Stress
Hardiness
a personality characteristic associated with a lower rate of stress-related illness
commitment
challenge
control
Social support
a mutual network of caring, interested others
Buffering hypothesis: protects individuals against the adverse effects of stress.
Direct effects hypothesis: provides individuals with a general resistance to stress.
Explanation of the relationship between social support and stress
Coping Styles - Information Seeking
attentional styles
monitoring (seeking relevant information)
vs. blunting (avoiding such information)
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Diabetics example. Agism
Locus of Control
a generalized belief about one’s ability to control events by virtue of one’s own efforts. Internal LOC: initiate change on their own; external LOC: more likely to be influenced by others. Considered to be a generalized belief rather than situation-specific
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Flu example
Locus of Control Scale
Internal HLC (IHLC) is the extent to which one believes that internal factors are responsible for health/illness.
Powerful Others HLC (PHLC) is the belief that one's health is determined by powerful others.
Chance HLC (CHLC) measures the extent to which one believes that health illness is a matter of fate. luck or chance.
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Handout Locus of Control Scales
Social Support
has both direct effects and stress-buffering effects on well-being. The stress-buffering hypothesis predicts that SS will strengthen in its positive effects on adjustment and physical well-being as a stressor becomes more intense or persistent
the direct effects of SS have been observed primarily in studies assessing the extent of SS networks
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Social support theory
Social Support
SS affects both primary (the availability of friends to talk to) and secondary (bolster beliefs about one’s ability to cope) appraisal
SS can serve as a mechanism for downward comparison
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Stress Management Interventions
Biofeedback
deep relaxation
cognitive-behavioral strategies (information seeking, direct action, inhibition of action, intrapsychic processes, turning to others for support)
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References
Antonovsky, A. (1979). Health, stress, and coping. San Francisco: Jossey-Bass.
Cannon, W. B. (1932). The wisdom of the body. New York: Norton.
Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., . . . Marks, J. S. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The Adverse Childhood Experience (ACE) Study. American Journal of Preventive Medicine, 14(4), 245-258.
Folkman, S., Lazarus, R., Dunkel-Schetter, C., DeLongis, Al, & Gruen, R. (1986). Dynamics of a stressful encounter: Cognitive appraisal, coping, and encounter outcomes. Journal of Personality and Social Psychology, 50, 992-1003.
Holmes, T. H., & Rahe, R. H. (1967). The Social Readjustment Rating Scale. Journal of Psychosomatic Research, 11, 213-218.
References
Lazarus, R. S. (1966). Psychological stress and the coping process. New York: McGraw-Hill.
Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal, and coping. New York: Springer.
Pearlin, L. I., & Schooler, C. (1978). The structure of coping. Journal of Health and Social Behavior, 19(1), 2-21.
Selye, H. (1956). The stress of life. New York: McGraw-Hill.
