3 Stress and Health Psychology

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Study and Review Guide

3 Stress and Health Psychology

OUTLINE (Survey & Question)

This outline is intended to help you survey the chapter. As you read through the various sections, write down any questions or comments that come to mind in the space provided. This is a valuable part of active learning and the SQ4R method. It not only makes your reading time more enjoyable and active, but it also increases retention and understanding of the material.

TOPICNOTES

I. HEALTH PSYCHOLOGY IN ACTION

1. What Health Psychologists Do

1. Smoking

1. Binge Drinking

Gender and Cultural Diversity: Binge Drinking Around the World

1. Chronic Pain

II. STRESS AND ITS ROLE IN HEALTH

1. Sources of Stress

1. Results of Stress

Research Highlight: Procrastination, Performance, and Health

III. STRESS AND SERIOUS ILLNESS

A. Cancer

1. Cardiovascular Disorders

IV. COPING WITH STRESS

1. Emotion-Focused Forms of Coping

B. Problem-Focused Forms of Coping

Critical Thinking/Active Learning: Is Your Job Stressful?

C. Resources for Effective Coping

D. Active Coping Strategies

Core and Expanded LEARNING OBJECTIVES (Read, Recite & wRite)

While reading the chapter, stop periodically and recite (or repeat in your own words) the answers to the following learning objectives. It will also help your retention if you write your answer in the space provided. (Page numbers refer to the text Psychology in Action, 6th Ed.)

Core Learning Objectives

These objectives are found at the beginning of each chapter of Psychology in Action (6th ed.).

1. What is health psychology? Can health psychologists help with problems related to smoking, binge drinking, and chronic pain?

1. What is stress and what are its major sources and results?

1. How is stress related to serious illnesses like cancer and coronary heart disease?

1. What techniques and resources are available to help people cope with stress?

Expanded Learning Objectives

These objectives offer more detail and a more intensive way to study the chapter.

Upon completion of CHAPTER 3, the student should be able to:

1. Define health psychology and state how it is related to life expectancy; identify major occupational options for health psychologists (pp. 88-89).

1. Describe the consequences of cigarette smoking; explain psychological, social, and biological factors that lead to smoking; and describe methods for prevention and quitting (pp. 89-91).
2. Discuss binge drinking on college campuses and around the world; describe how to reduce the social rewards that contribute to this problem (pp. 92-94).

1. Describe the role of psychologists in helping people deal with chronic pain (pp. 94-45).

1. Differentiate between stress and stressors, eustress and distress (p. 96).

1. Describe research findings related to Holmes and Rahe’s Social Readjustment Rating Scale, chronic stressors, daily hassles, frustrations, burnout, and conflict; differentiate between the three basic conflicts (pp. 96-99).

1. Describe the physiological effects of stress, including the general adaptation syndrome, the suppression of the immune system, and the development of physical disorders (pp. 101-103).

1. Describe how stress is related to cancer (pp. 104-105).

1. Explain the relationship between stress and heart disease, focusing on the autonomic nervous system, fatty deposits in the arteries, and cholesterol ratios (pp. 105-106).

1. Differentiate between Type A and Type B personalities; describe the research related to Type A personalities and heart disease; compare the shotgun and target behavior approaches to behavior modification (p. 106).

1. Describe the three attitudes common in people with the hardiness trait, and how these can affect stress (p. 107).

1. Contrast emotion-focused and problem-focused forms of coping with stress, and provide an example of each (pp. 108-110).

1. List coping resources and describe how each improves coping (pp. 110-111).

1. Explain how exercise, biofeedback, and relaxation can reduce stress (pp. 111-112).

KEY TERMS (Review)

The review step in the SQ4R method is very important to your performance on quizzes and exams. Upon completion of this chapter, you should be able to define the following terms.

Approach-Approach Conflict: ______

______

Approach-Avoidance Conflict: ______

______

Avoidance-Avoidance Conflict: ______

______

Burnout: ______

______

Chronic Pain: ______

______

Conflict: ______

______

Defense Mechanisms: ______

______

Distress: ______

______

Emotion-Focused Forms of Coping: ______

______

Eustress: ______

______

Frustration: ______

______

General Adaptation Syndrome (GAS): ______

______

Hardiness: ______

______

Hassles: ______

______

Health Psychology: ______

______

Locus of Control: ______

______

Problem-Focused Forms of Coping: ______

______

Psychoneuroimmunology: ______

______

Stress: ______

______

Type-A Personality: ______

______

Type-B Personality: ______

______

ACTIVE LEARNING EXERCISES (Recite)

The recite step in the SQ4R method requires you to be an ACTIVE learner. By completing the following exercises, you will test and improve your mastery of the chapter material, which will also improve your performance on quizzes and exams. Answers to some exercises appear at the end of this study guide chapter.

ACTIVE LEARNING EXERCISE I

After reading pages 108-110 of the text, try identifying both an emotion-focused and a problem-focused coping strategy for each of the following situations:

1. It is the first day of classes for a new semester and about five minutes into your first class you realize you are in classroom 242 not room 424. This is a physics class not a psychology class.

2. Your significant other has just told you that he/she is in love with someone else and is getting married next August.

3. Your car has stalled on a deserted country road. As you start to get out to check the problem, two large dogs run up to your door and start barking and growling at you.

4. Your car insurance has just been cancelled because of a mistake in your driving record.

5. You come to your history class expecting a normal lecture class, but you discover this is the day of the first major examination.

ACTIVE LEARNING EXERCISE II

Making Sound Decisions (A Cognitive Skill)

Good decision-makers take full responsibility for their own future. They realize they are the only ones who can truly evaluate the merits and potential costs of each alternative. A critical thinker also recognizes that decisions are often stressful, but cannot be avoided. Avoiding a decision is, in fact, making one without the benefit of a careful analysis of the problem. To improve your decision-making skills, we offer the following exercise (adapted from Seech, 1987):

1. At the top of the chart, identify an ongoing personal conflict as approach-approach, avoidance-avoidance, or approach-avoidance.

1. On the lines in the left-hand column, list all possible alternatives or possible courses of action. Although the wording of the "approach-approach" discussion may imply only two choices, most conflicts involve several options or alternatives. Identifying all your options will require a good deal of homework. Read up on your problem. Talk to as many people as you can.

1. Now list the logical outcome or consequence of each alternative, regardless of whether the consequence is significant or insignificant and regardless of whether it is a certain or a possible outcome.

1. Next assess both the probability and significance of each outcome. Using a 0 to 5 rating scale (0 = won't occur and 5 = certain to occur), assign a numerical rating for the likelihood that each consequence will actually occur. Using a similar 0 to 5 rating scale (0 = no significance and 5 = high significance), assess the importance you place on each consequence.

1. Now review the chart. In some cases, you may find it helpful to multiply your probability and significance ratings and then compare your results for the various alternatives. In other cases, you will find it difficult to assign numerical values to complex issues and feelings. Even in the most difficult decisions, however, the thinking and evaluation elicited by this chart may provide useful insights to your conflict. Also note the feelings you associate with each alternative. Careful decision making tries to integrate feelings and cognitions.

1. After you've reviewed each alternative, ask yourself which choice is most in line with your overall goals and values. Some alternatives may look more-or less appealing when weighed against long-term relationship plans, career goals, and personal belief systems. You may want to discuss your chart with a trusted friend before you make a final decision.

1. Once you make your decision, commit yourself and give it all you've got. Throw away your expectations. Many decisions don't turn out the way we imagine, and if we focus on the way it is supposed to be we miss enjoying the way it is. On the other hand, if the decision is wrong, don't be afraid to change or correct your course. (“When you’re in a hole, stop digging!”)

TYPE OF CONFLICT: ______

AlternativesLogical OutcomeProbability Significance

1.

2.

3.

CHAPTER OVERVIEW (Review)

The following CHAPTER OVERVIEW provides a narrative overview of the main topics covered in the chapter. Like the Visual Summary found at the end of each chapter in the text, this narrative summary provides a final opportunity to review chapter material.

I. Health Psychology in Action

Health psychology is the study of the relationship between psychological behavior and physical health and illness, with an emphasis on wellness and the prevention of illness. As researchers, health psychologists study psychological issues that affect physical health and find ways to help patients cope with medical procedures and health problems. As practitioners, health psychologists work with patients alongside health care professionals to help reduce psychological distress and unhealthy behaviors and educate the general public about health risks and health maintenance.

Because smoking is the single most preventable cause of death and disease in the United States, prevention and cessation of smoking are of primary importance to all health practitioners, including health psychologists. Smoking prevention programs involve educating the public about short- and long-term consequences of smoking, trying to make smoking less socially acceptable and helping nonsmokers resist social pressures to smoke. Most approaches to help people quit smoking include cognitive and behavioral techniques to aid smokers in their withdrawal from nicotine, and nicotine replacement therapy (using patches, gum, and pills).

Binge drinking is a serious problem, which can lead to rape or assault, and even to death from alcohol poisoning or automobile and other accidents. It occurs when a man has five or more drinks in a row and a woman has four or more. To reduce binge drinking, we must overcome the myths about drinking and teach the facts. We must also reduce or remove the social rewards.

Chronic pain is continuous or recurrent pain that persists over a period of six months or more.

Although psychological factors rarely are the source of chronic pain, they can encourage and intensify it. Increased activity, exercise, and dietary changes help to reduce chronic pain. Health psychologists also use behavior modification, biofeedback, and relaxation techniques to treat chronic pain.

II. Stress and Its Role in Health

Stress is the body's arousal, both physical and mental, to situations or events that we perceive as threatening or challenging. A situation or event, either pleasant or unpleasant, that triggers arousal and causes stress is known as a stressor.

The major sources of stress are life changes, chronic stressors, hassles, burnout, frustration, and conflicts. Chronic stressors are ongoing events such as poor working conditions. Hassles are little everyday life problems that pile up to cause major stress. Persistent hassles and a loss of idealism in your work situation can lead to a form of physical, mental, and emotional exhaustion known as burnout. Frustration has to do with blocked goals, whereas conflict involves two or more competing goals. Conflicts can be classified as approach--approach, avoidance--avoidance, or approach--avoidance.

When stressed, the body undergoes physiological changes. The sympathetic branch of the autonomic nervous system is activated, increasing heart rate and blood pressure. This sympathetic activation is beneficial if people need to fight or flee, but in today’s world, it generally has negative consequences.

Hans Selye described a generalized physiological reaction to severe stressors, which he called the general adaptation syndrome (GAS). It has three phases: the alarm reaction, the resistance phase, and the exhaustion phase. Prolonged stress can suppress the immune system, which can render the body susceptible to a number of diseases.

III. Stress and Serious Illness

Cancer appears to result from an interaction of heredity, environment (for example, smoking), and immune system deficiency. Stress may be an important cause of decreased immunity. The leading cause of death in the United States is heart disease. Risk factors in heart disease include smoking, stress, obesity, a high-fat diet, lack of exercise, and Type A personality (if it includes cynical hostility). The two main approaches to modifying Type A behavior are the shotgun approach and the target behavior approach. People with psychological hardiness are less vulnerable to stress because of three distinctive personality characteristics—commitment, control, and challenge.

IV. Coping with Stress

The two major forms of coping with stress are emotion-focused and problem-focused. Emotion-focused forms change how we view stressful situations. Problem-focused forms deal directly with the situation or the factor causing the stress so as to decrease or eliminate it.

The ability to cope with a stressor also depends on the resources available to a person. Resources include health and energy, positive beliefs, an internal locus of control, social skills, social support, and material resources. Exercise and progressive relaxation are active methods people can use to cope with stress.

SELF-TESTS (Review & wRite)

Completing the following SELF-TESTS will provide immediate feedback on how well you have mastered the material. In the crossword puzzle and fill-in exercises, write the appropriate word or words in the blank spaces. The matching exercise requires you to match the terms in one column to their correct definitions in the other. For the multiple-choice questions in Practice Tests I and II, circle or underline the correct answer. When you are unsure of any answer, be sure to highlight or specially mark the item and then go back to the text for further review. Correct answers are provided at the end of this study guide chapter.

Crossword Puzzle for Chapter 3

ACROSS

7 A negative emotional state caused by an inability to choose between two or more incompatible goals or impulses.

9 Unpleasant, objectionable stress.

10 Unconscious strategies used to distort reality and relieve anxiety and guilt

13 Pleasant, desirable stress.

14 A state of physical, emotional, and mental exhaustion attributable to long-term involvement in emotionally demanding situations.

15 Set of behavior characteristics consistent with a calm, patient, relaxed attitude toward life.

16 As described by Selye, a generalized physiological reaction to severe stressors consisting of three phases: the alarm reaction, the resistance phase, and the exhaustion phase.

DOWN

1 Continuous or recurrent pain over a period of six months or more.

2 The study of the relationship between psychological behavior and physical health and illness, with an emphasis on wellness and the prevention of illness.

3 Set of behavior characteristics that includes intense ambition, competition, drive, constant preoccupation with responsibilities, exaggerated time urgency, and a cynical, hostile outlook.

4 An interdisciplinary field that studies the effects of psychological factors on the immune system.

5 A resilient personality characteristic based on three qualities: a commitment to personal goals, control over life, and viewing change as a challenge rather than a threat.

6 Little problems of daily living that are not significant in themselves, but they accumulate and sometimes become a major source of stress.

8 A person's belief about whether the results of their successes or failures are under their personal control (internal) or outside their control (external).

11 An unpleasant state of tension, anxiety, and heightened sympathetic activity resulting from a blocked goal.

12 A nonspecific response of the body to any demand made on it; the arousal, both physical and mental, to situations or events that we perceive as threatening or challenging.

FILL-IN EXERCISES

1. The study of the relationship between psychological behavior and physical health and illness is known as ______(p. 88)

1. An increase in activity and exercise levels can be beneficial to pain patients because exercise increases the release of ______(p. 94).

1. According to the U.S. Department of Health and Human Services, the single most preventable cause of death and disease in the United States is ______(p. 89).

1. ______occurs when a man consumes 5 or more drinks in a row or a woman consumes 4 or more (p. 92)

1. The text defines stress as “ a ______response of the body to any ______made on it (p. 96).

1. Selye called ______beneficial, pleasant, or desirable stress (p. 96).

1. Having to choose between two alternatives that will both lead to undesirable results is known as a(n) ______conflict (p. 99).

1. The three-phase bodily response to chronic stress (Selye’s general adaptation syndrome), includes the ______, the ______, and the ______(p. 102).

1. Being hard driving, competitive, ambitious, impatient, and hostile is characteristic of the ______personality; whereas having a laid-back, calm, relaxed attitude toward life is typical of the ______personality (p. 106).

1. If you decide to confront a coworker to tell him/her that they are not doing their share of the work, you are using a ______coping strategy (p. 108).

MATCHING EXERCISES

Column AColumn B

1. Problem-Focused Strategy1.____Small everyday problems.
2. Defense Mechanisms2.____ Studies effect of psychological function on immune

system.

1. Hassles3.____Exhaustion from emotionally demanding situations.
2. Frustration 4.____Unpleasant state from two or more competing goals.
3. Burnout5.____ Conflict with both desirable and undesirable goals.
4. Type A personality6.____Unconscious strategies that protect the ego.
5. Psychoneuroimmunology7.____Deals directly with the stress with problem-solving.
6. Approach-Avoidance8.____Alarm reaction, resistance, and exhaustion phase.
7. Hans Selye9.____Unpleasant state resulting from blocked goal.
8. Conflict 10.____Ambitious, competitive, hard driving.

PRACTICE TEST I