Stress and Coping BBH 101 lecture outline Prof Smyth, Spring 2013

Stress and Coping Defining Stress Is stress objective or subjective? Examples of objective/subjective Getting shot? An imagined tryst or threat?

Defining Stress How do you know when you are under stress? Can positive events be stressful?

How does stress differ from anticipation? Excitement? Other emotions? Two factor theories of emotion What is Stressful?

Definitions of Terms Stressor: an external event or situation that may threaten us Stress: the psychological and physical state produced by recognizing a stressor (external threat)

Stress is influenced by objective reality, but is largely a subjective response Stressor Appraisal

Intensity of the Stress Response Dynamics of a stressful experience Stressor (event) Appraisal (primary) Assessment of coping resources (secondary appraisal) Re-appraisal Buffering and/or moderators Immediate outcomes Coping Secondary outcomes Feedback loops (indirect effects)

The big brain problem; redux Remember that vividly imagining a stressful event can produce physiological effects nearly identical to actually experiencing the event Worry, rumination, perseverative cognition stinkin thinkin

Underscores the importance of the mind in our health - a stressor does not even have to present to produce health risks! Particularly vital in extending stress effects into chronicity

Stress disjunctions Some people have a disconnect between the objective and subjective aspects of an experience with regard to stress Repressors Suppressors

Chronic stress What is CHRONIC stress?

What makes it chronic? Persistent event Persistent response to terminated event Repeating acute event or events

So what is stress? Both objective and subjective parameters seem to contribute to health and well-being Subjective seems more important

Both daily hassles and major life events influence health and well-being seem to potentiate each other

Ideally we should search for convergent validity across assessment domains problems of repression/supression

Individual Stress, Trauma, and Health Major life events loss of a loved one, divorce, etc.

Hassles and uplifts daily events such as misplacing something, getting stuck in traffic, or a compliment

A word on the prevalence of trauma and its negative effects Prevalence and nature of trauma/life events

death of a loved one divorce or separation of parents a traumatic sexual experience a traumatic violent experience an upheaval/other traumatic experience, that you feel may have changed your personality Overall, 66.1% reported experiencing at least one traumatic events

Childhood Trauma and Health

Stress and the common cold The nose knows

Is stress related to the onset of illness after viral exposure? Sheldon Cohens common cold studies... Stress and likelihood of illness Stress and illness severity Stress and the common cold

Stress increased likelihood of becoming ill following viral exposure Controlled, experimental design Greater stress also increased the severity and longevity of illness Stress variability was well within normal ranges Lower stress made it less likely you would become sick and, if you did, your illness was less severe and went away faster

Coping with stress and trauma Overview of Coping Strategies Coping

efforts made to respond to (or handle) stress

What can be considered coping? What is good coping?

Can distinguish on several broad dimensions active/passive emotional/instrumental anticipatory/responsive Coping Strategies

Social Support What is social support? Feeling included, valued, and cared-for by others

Is social support always positive? Social Support For the moment, we shall focus on positive social support

Social Support Stress and social support direct effects indirect effects

Who can provide social support? Family, friends Pets? Plants? Photographs?

Social support and survival Alameda County study

What is the link between social support and health?

Alameda County, CA study 7000 men and women in 1965 Index based on social ties

Compared those with low scores (lack of social ties) against those with high scores (more social ties) Examined all cause mortality 9 years later Mortality rates 1.9 to 3 times greater in those lacking social ties Results have been replicated in U.S. and Europe

Social support and 9-year mortality Social Contact % Males Dead 9.6 12.1 18.2 Lowest 30.8 % Females Dead 7.3 4.9 8.0 15.3

I II III IV

Highest

The Nature of Mental Control: Dont Think About This Why, and how, do we think about stressful events? make sense of incoherent experience paradox of ruminations

Thought suppression The famous white bear

Failure of mental control addictive disorders, diets, etc.

Stress management What to do when life has got you down Stress management We have examined several broad coping styles

standard coping efforts Can also use psychological interventions

What about body oriented approaches? Standard wellness approaches health behavior modification

Relaxation methods

More formal stress management programs Themes common to stress management Typically follows a three step approach Education Skill acquisition Practice

Multiple approaches are typically superior to just one Stressed? Anxious? Recall that the physiological basis of this feeling is sympathetic arousal in the ANS Can we promote better/more parasympathetic activity?

Relaxation Methods The Relaxation Response Biofeedback Volitional control over autonomic responses

Hypnosis Massage Direct approaches to relaxation breathing, PMR, imagery, meditation, etc.